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Schuch A, Walther P, Timm L, Steinbach K, Haneklaus L, Münzel T, Prochaska JH, Wild PS. [Utilization of video consultation in cardiovascular lipid treatment]. Herz 2024; 49:224-232. [PMID: 37855873 PMCID: PMC11136760 DOI: 10.1007/s00059-023-05211-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 07/04/2023] [Accepted: 09/01/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND Video consultation is a possibility for physician-patient communication independent of the location; however, only limited information is available for the possibility of sole use since 2018. METHODS After the implementation of video consultation (Viomedi) in lipid consultations at the Medical University Mainz, the patients in the first quarter of 2022 were assessed depending on the possibility, suitability and readiness to participate. Included were patients under lipid management and long COVID patients. After treatment an online survey was carried out on the utilization and appraisal. RESULTS Of the 134 patients 29.1% were inclusively treated (3 refusals). All subjects (16 replies) reported having managed (very) well. Advantages were seen in counselling and follow-up. Problems were feared with respect to technology and possible disorders. Data protection aspects played a subordinate role. In comparison to telephone calls, a significant improvement in the physician-patient relationship (p-value = 0.00027), the quality of treatment and information (p-value both = 0.00044), the access to care (p-value = 0.0053) and the communication (p-value = 0.021) was assumed. An improvement in access to care (p-value = 0.021) and the quality of information (p-value = 0.034) was seen in comparison to personal contact. The main problems were a lack of experience, technical requirements, technical problems and unpunctuality of the practitioner. The flexibility, low effort and the pleasant consultation were all praised. All subjects wanted to use the video consultation again. CONCLUSION Video consultation can represent a supplement to treatment of patients under lipid management. The correct use requires exact planning and further research.
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Affiliation(s)
- A Schuch
- Zentrum für Kardiologie, Kardiologie I, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, Mainz, Deutschland
- Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Rhein-Main, 55131, Mainz, Deutschland
| | - P Walther
- Hochschule Fresenius, Hochschule für Angewandte Wissenschaften, 20095, Hamburg, Deutschland.
| | - L Timm
- Hochschule Fresenius, Hochschule für Angewandte Wissenschaften, 20095, Hamburg, Deutschland
| | - K Steinbach
- Zentrum für Kardiologie, Kardiologie I, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, Mainz, Deutschland
- Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Rhein-Main, 55131, Mainz, Deutschland
| | - L Haneklaus
- Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Rhein-Main, 55131, Mainz, Deutschland
| | - T Münzel
- Zentrum für Kardiologie, Kardiologie I, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, Mainz, Deutschland
- Präventive Kardiologie und Medizinische Prävention, Zentrum für Kardiologie, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, Mainz, Deutschland
- Klinische Epidemiologie und Systemmedizin, Centrum für Thrombose und Hämostase, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, 55131, Mainz, Deutschland
| | - J H Prochaska
- Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Rhein-Main, 55131, Mainz, Deutschland
- Forschungszentrum Translationale Vaskuläre Biologie (CTVB), Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, Mainz, Deutschland
- Präventive Kardiologie und Medizinische Prävention, Zentrum für Kardiologie, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, Mainz, Deutschland
- Klinische Epidemiologie und Systemmedizin, Centrum für Thrombose und Hämostase, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, 55131, Mainz, Deutschland
| | - P S Wild
- Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Standort Rhein-Main, 55131, Mainz, Deutschland
- Forschungszentrum Translationale Vaskuläre Biologie (CTVB), Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, Mainz, Deutschland
- Präventive Kardiologie und Medizinische Prävention, Zentrum für Kardiologie, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, Mainz, Deutschland
- Klinische Epidemiologie und Systemmedizin, Centrum für Thrombose und Hämostase, Universitätsmedizin der Johannes-Gutenberg-Universität Mainz, 55131, Mainz, Deutschland
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Hofmann UK, Hildebrand F, Mederake M, Migliorini F. Telemedicine in orthopaedics and trauma surgery during the first year of COVID pandemic: a systematic review. BMC Musculoskelet Disord 2023; 24:101. [PMID: 36750962 PMCID: PMC9903270 DOI: 10.1186/s12891-023-06194-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/24/2023] [Indexed: 02/09/2023] Open
Abstract
PURPOSE Prior to the COVID-19 pandemic, telemedicine in orthopaedics and trauma surgery had mostly developed for joint arthroplasty, fracture management, and general pre- and postoperative care including teleradiology. With the corona-outbreak, telemedicine was applied on a broad scale to prevent assemblage and to guarantee access to medical care protecting critical areas. The purpose of the present study was to give an overview of the spectrum of clinical applications and the efficacy of telemedicine in orthopaedic and trauma surgery as published in times of the COVID-19 pandemic. METHODS All published studies investigating the application of telemedicine related to orthopaedics and trauma during the COVID-19 pandemic were accessed and screened for suitability. The primary outcome of interest was the efficacy of telemedicine in various clinical applications. The secondary outcome of interest was the spectrum of different applications in which telemedicine applications were investigated. RESULTS The literature search resulted in 1047 articles. After the removal of duplicates, 894 articles were screened of which 31 finally met the inclusion criteria. Dimensions that were described by studies in the literature to have positive effects were preoperative patient optimisation, the usefulness of telemedicine to correctly diagnose a condition, conservative treatment, willingness to and feasibility for telemedicine in patients and doctors, and postoperative/post-trauma care improvement. The efficacy of telemedicine applications or interventions thereby strongly varied and seemed to depend on the exact study design and the research question addressed. CONCLUSION Various successful applications of telemedicine have already been reported in orthopaedics and trauma surgery, with a strong increase in scientific output during the COVID-19 years 2020-2021. Whether the advantages of such an approach will lead to a relevant implementation of telemedicine in everyday clinical practice should be monitored after the COVID-19 pandemic.
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Affiliation(s)
- Ulf Krister Hofmann
- grid.412301.50000 0000 8653 1507Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, Aachen, 52074 Germany
| | - Frank Hildebrand
- grid.412301.50000 0000 8653 1507Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, Aachen, 52074 Germany
| | - Moritz Mederake
- grid.10392.390000 0001 2190 1447Department of Trauma and Reconstructive Surgery, BG Klinik, University of Tübingen, Tübingen, 72076 Germany
| | - Filippo Migliorini
- Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, Pauwelsstraße 30, Aachen, 52074, Germany.
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Daentzer D. Video Consultations and Their Utilization by Orthopedic and Trauma Surgeons During the COVID-19 Pandemic. A Go-To Technology in the Future or Just a Stopgap? ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2023; 161:29-41. [PMID: 34255343 DOI: 10.1055/a-1471-8919] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, the contact restrictions imposed for protection against infection have limited the options for direct medical therapy. Considering this, the present study aimed to evaluate the utility of the rarely used online video consultation as an alternative treatment form for orthopedic and trauma surgeons and analyze its potential for future use. METHODS During calendar week 24 in the year 2020, 215 specialists in orthopedics and orthopedics and trauma surgery in the city and greater region of Hanover, Germany, were enrolled in a questionnaire-based evaluation of their use of video consultations. The analysis consisted of 125 completed questionnaires, which corresponded to a return rate of 58.1%. The completed questionnaires recorded the number of users, frequency of utilization, and advantages and disadvantages of online treatment, as well as provided an assessment of the future use of telemedicine and video consultations. Furthermore, we considered the necessary requirements for using video consultations and for continuing their use in the future as well as the potential of performing online consultations given that all pertinent conditions are fulfilled. RESULTS Among the 125 respondents, only 17 (13.6%) had already experienced video consultations, all starting during the COVID-19 pandemic, but with very low frequencies (maximum of one-three times per week). Despite the limitations, the advantages included helping patients receive the required treatments and reducing the need for travel. However, the respondents mentioned that there were several disadvantages due to diagnostic limitations: there was no direct examination, primary consultations were restricted, and possibilities of consultations and explanations were reduced. Of the 108 (86.4%) respondents who had not experienced video consultations, only 9 (8.3%) had specifically planned to conduct online consultation, whereas 57 (52.8%) had no such intention in the foreseeable future and 42 (38.9%) were undecided on this point. They stated diagnostic limitations because of the lack of direct examination (44/77.2%) and the indispensable personal contact with the patient (30/52.6%) as main counter-arguments. According to all the respondents, the main requirements for the implementation of video consultations included establishment of proper technology (81.6%), adequate remuneration (61.6%), legal certainty (58.4%), fast and unbureaucratic support for installation and in case of problems (51.2%), and a manageable bureaucracy during the initial period (44.8%). CONCLUSION Video consultations and telemedicine in general undoubtedly have advantages, primarily concerning the protection from infection and contact restrictions, which are increasingly requested by patients. However, the collected data indicate that this approach may remain less important than personal consultations in the field of orthopedics and trauma surgery. As suggested by available data, this does not apply to other fields such as psychotherapy or general medicine.
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Affiliation(s)
- Dorothea Daentzer
- Wirbelsäulendepartment, Orthopädische Klinik der MHH im DIAKOVERE Annastift, Hannover
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Manych M. Digitale Klinik, digitale Orthopädie und Unfallchirurgie – noch eher Vision oder bereits Realität? ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE 2022; 160:481-483. [PMID: 36167080 DOI: 10.1055/a-1388-2368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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