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Khera M, Bernie HL, Broderick G, Carrier S, Faraday M, Kohler T, Jenkins L, Watter D, Mulhall J, Raheem O, Ramasamy R, Rubin R, Spitz A, Yafi F, Sadeghi-Nejad H. Sexual Medicine Society of North America (SMSNA)/American Urological Association (AUA) telemedicine and men's health white paper. J Sex Med 2024; 21:318-332. [PMID: 38430132 DOI: 10.1093/jsxmed/qdad151] [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: 07/28/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 03/03/2024]
Abstract
PURPOSE The purpose of this white paper is to educate health care professionals about the evolution of telemedicine (TM) and to propose a hybrid model that leverages the strengths of traditional in-person medicine as well as virtual medicine while maximizing the safety and quality of men's sexual health care. LITERATURE SEARCH STRATEGY A literature search focused on the use of TM in urology and men's health was performed through PubMed/MEDLINE, Embase, and Web of Science (January 1, 2012-April 26, 2022). Keywords included all known permutations of the terminology used to refer to virtual health, care as well as the terminology used to refer to urologic diseases, issues specific to men's health, and men's sexual health concerns. Publications that emerged after the literature search that met this criterion also were incorporated. Opinion pieces, letters to the editor, meeting abstracts, and conference proceedings were excluded. Additional resources were retrieved, such as governmental technical reports, legislative updates and reviews, and blogs. This search strategy yielded 1684 records across databases after removal of duplicates. Abstracts from the retrieved records were reviewed for relevance. Relevant publications were defined as those that reported data on any aspect of TM use specific to urology, men's health, and/or men's sexual health. If relevance was unclear from the abstract, then the full text of the article was retrieved for a more detailed review. In addition, the published evidence-based practice guidelines relevant to care for erectile dysfunction, Peyronie's disease, ejaculatory dysfunction, and hypogonadism were retrieved. The most common reasons for article exclusions were a focus on TM use in disciplines other than urology and the absence of data (ie, opinion pieces). After exclusions, a total of 91 publications remained and constituted the evidence base for this paper.
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Affiliation(s)
- Mohit Khera
- Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, United States
| | - Helen L Bernie
- Department of Urology, Indiana University, Indianapolis, IN 46202, United States
| | - Gregory Broderick
- Department of Urology, Mayo Clinic Alix School of Medicine, Jacksonville, Florida 32224, United States
| | - Serge Carrier
- Surgical Department /Urology Division, McGill University, Montreal, Quebec, H4A 3J1, Canada
| | - Martha Faraday
- Four Oaks Consulting, Berryville, VA 22611, United States
| | - Tobias Kohler
- Department of Urology, Mayo Clinic, Rochester, MN 55905, United States
| | - Lawrence Jenkins
- Department of Urology, Tulane University School of Medicine, New Orleans, LA 70112, United States
| | - Daniel Watter
- Morris Psychological Group, P.A., Parsippany, NJ 07054, United States
| | - John Mulhall
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10022, United States
| | - Omer Raheem
- Section of Urology, Department of Surgery, University of Chicago, Chicago, IL 60637, United States
| | - Ranjith Ramasamy
- Desai Sethi Urology Institute, University of Miami Miller School of Medicine, Miami, FL 33136, United States
| | - Rachel Rubin
- Department of Urology, Georgetown University, Washington, DC 20007, United States
| | - Aaron Spitz
- Orange County Urology Associates, Laguna Hills, California, CA 92653, United States
| | - Faysal Yafi
- Department of Urology, University of California Irvine, CA 92660, United States
| | - Hossein Sadeghi-Nejad
- Department of Urology, NYU Langone Grossman School of Medicine, New York, NY 10017, United States
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Rotter G, Binting S, Teut M, Ortiz M, Willich SN, Brinkhaus B. Characteristics of Patients Presenting at a University Outpatient Department for Complementary and Integrative Medicine. Complement Med Res 2023; 30:279-288. [PMID: 36804827 DOI: 10.1159/000529798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/20/2023] [Indexed: 02/22/2023]
Abstract
BACKGROUND Complementary and integrative medicine (CIM) is increasingly provided at university outpatient departments (OPDs) in Germany, but its scientific evaluation is sparse. Therefore, we aimed to investigate and evaluate feasibility, patients' characteristics and complaints at a university's CIM-OPD. METHODS A prospective evaluation included new patients without age restriction. At baseline, and after 6 and 12 months, patients filled out paper questionnaires. Patients rated their mean subjectively perceived severity of the main complaint within the last 7 days on a numerical rating scale (NRS) from 0 = no complaints to 10 = maximum complaints, their perceived resilience capacity in everyday life within the last 7 days (0 = not resilient to 10 = very resilient), and their contentment with the treatment (0 = not content to 10 = very content). Diagnoses were provided by physicians and coded according to the International Statistical Classification of Diseases and Related Health Problems, 10th revision. All data were analyzed descriptively. RESULTS During two years, 536 new patients {72.6% response, age (mean ± standard deviation [SD] and range) 49.6 ± 15.8 and 1-86 years, 75.7% female} chose to participate. The most frequent diagnosis groups were neoplasms (C00-C97, n = 143, 18.6%) and musculoskeletal diseases (M00-M99, n = 137, 17.9%). In n = 165 patients (30.8%), more than one diagnosis was provided. In a subgroup of 187 patients, who returned the questionnaire after 6 months, we compared baseline to 6-month values: severity of main complaint (mean ± SD) 5.2 ± 2.6 changed to 3.9 ± 2.6; resilience capacity 5.1 ± 2.6 to 5.6 ± 2.4. After 6 months, respondents rated their contentment with the treatment with (mean ± SD) 7.7 ± 2.6. Data after 12 months (n = 113) are comparable to data after 6 months. CONCLUSION Patients of our CIM-OPD had a broad age range, were predominantly female, and suffered mostly from oncologic-related complaints and musculoskeletal diseases. In the responding subgroup after 6 months, patients were content with the treatment. These results should be verified by further prospective evaluations. Hintergrund Komplementäre und integrative Medizin (CIM) wird in Deutschland zunehmend in Hochschulambulanzen (OPDs) angeboten, deren wissenschaftliche Evaluation ist jedoch unzureichend. Deshalb war es unser Ziel, die Durchführbarkeit einer Evaluation, die Charakteristika und die Beschwerden der Patienten und Patientinnen an einer CIM-ODP zu untersuchen. Methoden Eine prospektive Evaluation schloss neue Patienten und Patientinnen ohne Altersbeschränkung ein. Zu Baseline sowie nach sechs und 12 Monaten füllten die Patienten und Patientinnen Papierfragebögen aus. Die Patienten und Patientinnen bewerteten ihre mittlere subjektiv empfundene Schwere der Hauptbeschwerden in den letzten sieben Tagen auf einer numerischen Ratingskala (NRS) von 0 = keine Beschwerden bis 10 = maximale Beschwerden, ihre mittlere subjektiv empfundene Belastbarkeit im Alltag in den letzten sieben Tagen (0 = nicht belastbar bis 10 = sehr belastbar) und ihre Zufriedenheit mit der Behandlung (0 = nicht zufrieden bis 10 = sehr zufrieden). Die Diagnosen wurden von den Ärzten und Ärztinnen gestellt und nach der International Statistical Classification of Diseases and Related Health Problems, 10. Revision, kodiert. Die Daten wurden deskriptiv ausgewertet. Ergebnisse Im Laufe von zwei Jahren nahmen 536 neue Patienten und Patientinnen (72.6% Rücklauf, Alter (Mittelwert ± SD und Range) 49.6 ± 15.8 und 1–86 Jahre, 75.7% weiblich) teil. Die häufigsten Diagnosen waren Neoplasmen (C00-C97, n = 143, 18.6%) und Erkrankungen des Bewegungsapparates (M00-M99, n = 137, 17.9%). Bei n = 165 (30.8%) Patienten und Patientinnen wurde mehr als eine Diagnose vergeben. In einer Subgruppe von 187 Patienten und Patientinnen, die den Fragebogen nach 6 Monaten zurücksendeten, verglichen wir die Ausgangs-und 6-Monats-Werte: Schweregrad der Hauptbeschwerden (Mittelwert±SD) 5.2 ± 2.6 veränderte sich zu 3.9 ± 2.6; Belastbarkeit 5.1 ± 2.6 zu 5.6 ± 2.4. Nach sechs Monaten bewerteten die Befragten ihre Zufriedenheit mit der Behandlung mit (Mittelwert±SD) 7.7 ± 2.6. Die Daten nach 12 Monaten ( n = 113) sind mit den Daten nach 6 Monaten vergleichbar. Schlussfolgerung Die Patienten und Patientinnen unserer CIM-OPD hatten eine breite Altersspanne, überwiegend weiblich und litten zumeist unter onkologisch bedingten Beschwerden und Erkrankungen des Bewegungsapparates. Patienten und Patientinnen der nach sechs Monaten antwortenden Subgruppe waren mit der Behandlung zufrieden. Die Ergebnisse sollten durch weitere prospektive Evaluationen verifiziert werden.
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Affiliation(s)
- Gabriele Rotter
- Institute of Social Medicine, Epidemiology and Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sylvia Binting
- Institute of Social Medicine, Epidemiology and Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Teut
- Institute of Social Medicine, Epidemiology and Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Miriam Ortiz
- Institute of Social Medicine, Epidemiology and Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan N Willich
- Institute of Social Medicine, Epidemiology and Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Benno Brinkhaus
- Institute of Social Medicine, Epidemiology and Health Economics, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Gómez Rivas J, Somani B, Rodriguez Socarrás M, Marra G, Pearce I, Henningsohn L, Zondervan P, van der Poel H, Van Poppel H, N'Dow J, Liatsikos E, Palou J. Essentials for Standardising the Undergraduate Urology Curriculum in Europe: Outcomes of a Delphi Consensus from the European School of Urology. EUR UROL SUPPL 2021; 33:72-80. [PMID: 34738091 PMCID: PMC8551509 DOI: 10.1016/j.euros.2021.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 01/15/2023] Open
Abstract
Background The burden of urological diseases is rising as the worldwide population ages. Although specialist urological provision is needed, a large proportion of these conditions will be managed in primary care. The importance of including urology in medical education currently remains unclear. Objective To provide recommendations on undergraduate medical education for urology in Europe. Design, setting, and participants A three-round Delphi process to reach consensus on standardising the undergraduate urology curriculum in Europe was endorsed by the European School of Urology. Outcome measurements and statistical analysis The levels of agreement were set using a nine-point scale according to the GRADE grid: 1–3, disagree; 4–6, uncertain; and 7–9, agree. Consensus was defined as at least 70% of the participants scoring within the same 3-point grouping. Results and limitations Overall, consensus was reached for 20 of 34 statements (70.5%) across the three Delphi rounds, with agreement for 75% (n = 15) and disagreement for 25% (n = 5). The following main points were agreed. Urological teaching should be introduced before year 5 of medical school, with at least 20 h of theoretical activities and at least 30 h of practical activities. Urology should be taught as a stand-alone subject rather than combined with another surgical specialty or a nephrology programme. The participants agreed that urology should be taught according to symptoms. A urology programme should include the anatomy and physiology of the urinary tract, and students should know how to clinically assess a urological patient. Conclusions Our recommended urology pathway will allow European medical schools to provide a more comprehensive undergraduate urology curriculum. It will also help to improve and maintain standards of urology undergraduate teaching across Europe. Patient summary Our survey showed that urology in universities should have, at minimum, time for theoretical and practical activities and should be taught as a stand-alone subject on the basis of symptoms. Students should give feedback to facilitate constant improvement and evolution of the teaching programme.
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Affiliation(s)
- Juan Gómez Rivas
- Department of Urology, Hospital Clínico San Carlos, Madrid, Spain
| | - Bhaskar Somani
- University Hospital Southampton NHS Trust, Southampton, UK
| | | | - Giancarlo Marra
- Department of Urology, San Giovanni Battista Hospital, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Ian Pearce
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Lars Henningsohn
- Department of Urology, Karolinska University Hospital, Stockholm, Sweden
| | - Patricia Zondervan
- Department of Urology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Henk van der Poel
- Department of Urology, The Netherlands Cancer Institute, Netherlands Prostate Cancer Network, Amsterdam, The Netherlands
| | | | - James N'Dow
- Academic Urology Unit, University of Aberdeen, Aberdeen, UK
| | | | - Joan Palou
- Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, Barcelona, Spain
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Socioeconomic factors that impact patient no-shows in the ambulatory urology clinic. J Public Health (Oxf) 2020. [DOI: 10.1007/s10389-020-01406-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Sarmah PB, Broadley GA, Khwaja S, Delves GH. Clinical Safety and Cost-Effectiveness of Follow-up Virtual Clinic for Bladder Outflow Obstruction Surgery. J Endourol 2020; 34:1161-1166. [PMID: 32668986 DOI: 10.1089/end.2020.0319] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Introduction: Bladder outflow obstruction (BOO) surgery is among the most commonly performed urologic procedures. Postoperative assessment consists of physical measurement of uroflowmetry and post-void residual volume, but health systems worldwide have experienced pressures in demand, leading to exploration of greater efficiency in organizing clinic protocols. International Prostate Symptom Score (IPSS) questionnaire measurement has been identified as a tool to predict change in postoperative management. Our institution established a nurse-led follow-up virtual clinic (VC) for patients undergoing BOO surgery based on IPSS measurement. We present the clinical and economic outcomes of this new service. Materials and Methods: Patients with a successful postoperative trial without catheter were contacted by telephone via VC and discharged by a Urology Clinical Nurse Specialist (UCNS) if IPSS was <8. Data were analyzed for IPSS, arrangement of subsequent clinic visits, and numbers discharged. Primary outcome was the proportion of patients discharged after VC consultation. Secondary outcomes were overall discharge rate following subsequent face-to-face (FTF) appointment; and the proportion of patients re-referred from Primary Care within 3 months of discharge from VC. Cost savings were calculated based on tariffs of £135 for first attendance with UCNS, £199 for uroflowmetry, and £47.84 for VC appointment. Results: The first 50 patients to be recipients of the new VC were included. The median IPSS and quality-of-life score were 13 (interquartile range [IQR] 5) and 3 (IQR 1), respectively. Thirty-nine (78%) patients were discharged from VC; 36 (72%) had IPSS <8. Overall discharge rate following subsequent FTF appointment was 88%. Two patients discharged from VC (5.1%) were subsequently re-referred, neither of whom required additional treatment. Total cost savings with VC amounted to £10,634. Conclusion: Telephone follow-up for BOO surgery based on IPSS is clinically safe and cost-effective, providing greater efficiency for clinic protocols.
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Affiliation(s)
| | | | - Sikandar Khwaja
- Department of Urology, Queen's Hospital Burton, Burton-on-Trent, United Kingdom
| | - George Henry Delves
- Department of Urology, Queen's Hospital Burton, Burton-on-Trent, United Kingdom
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Edison MA, Connor MJ, Miah S, El-Husseiny T, Winkler M, Dasgupta R, Ahmed HU, Hrouda D. Understanding virtual urology clinics: a systematic review. BJU Int 2020; 126:536-546. [PMID: 32463991 DOI: 10.1111/bju.15125] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To perform a systematic review to identify the clinical, fiscal and environmental evidence on the use of urological telehealth and/or virtual clinic (VC) strategies, and to highlight research gaps in this rapidly evolving field. METHODS Our PROSPERO-registered (CRD42019151946) systematic search of Embase, Medline and the Cochrane Review Database was performed to identify original research articles pertaining to adult urology telehealth or VC strategies. Risk-of-bias (RoB) assessment was performed according to the Cochrane 2.0 RoB tool or the Joanna Briggs Institute Checklist for non-randomized studies. RESULTS A total of 5813 participants were included from 18 original articles (two randomized controlled trials [RCTs], 10 prospective studies, six retrospective studies). Urology sub-specialities comprised: uro-oncology (n = 6); general urology (n = 8); endo-urology (n = 2); and lower urinary tract symptoms and/or incontinence (n = 2). Across all sub-specialties, prospective studies using VCs reported a primary median (interquartile range [IQR]) VC discharge rate of 16.6 (14.7-29.8)% and a primary median (IQR) face-to-face (FTF) clinic referral rate of 32.4 (15.5-53.3)%. Direct cost analysis demonstrated median (IQR) annual cost savings of £56 232 (£46 260-£61 116). Grade II and IIIb complications were reported in two acute ureteric colic studies, with rates of 0.20% (3/1534) and 0.13% (2/1534), respectively. The annual carbon footprint avoided ranged from 0.7 to 4.35 metric tonnes of CO2 emissions, depending on the mode of transport used. Patient satisfaction was inconsistently reported, and assessments lacked prospective evaluation using validated questionnaires. CONCLUSION Urology VCs are a promising new platform which can offer clinical, financial and environmental benefits to support an increasing urological referral burden. Further prospective evidence is required across urological sub-specialties to confirm equivalency and safety against traditional FTF assessment.
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Affiliation(s)
- Marie Alexandra Edison
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Martin John Connor
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.,Division of Surgery, Imperial Prostate I Department of Surgery and Cancer, Imperial College London, London, UK
| | - Saiful Miah
- Department of Urology, Wycombe Hospital, Buckinghamshire Healthcare NHS Trust, Amersham, UK
| | - Tamer El-Husseiny
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Mathias Winkler
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.,Division of Surgery, Imperial Prostate I Department of Surgery and Cancer, Imperial College London, London, UK
| | - Ranan Dasgupta
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - Hashim Uddin Ahmed
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK.,Division of Surgery, Imperial Prostate I Department of Surgery and Cancer, Imperial College London, London, UK
| | - David Hrouda
- Imperial Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK
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Al-Jabir A, Kerwan A, Nicola M, Alsafi Z, Khan M, Sohrabi C, O'Neill N, Iosifidis C, Griffin M, Mathew G, Agha R. Impact of the Coronavirus (COVID-19) pandemic on surgical practice - Part 1. Int J Surg 2020; 79:168-179. [PMID: 32407799 PMCID: PMC7214340 DOI: 10.1016/j.ijsu.2020.05.022] [Citation(s) in RCA: 159] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/06/2020] [Accepted: 05/09/2020] [Indexed: 01/08/2023]
Abstract
The Coronavirus (COVID-19) pandemic has resulted in over 4.5 million confirmed cases and over 300,000 deaths. The impact of COVID-19 on surgical practice is widespread, ranging from workforce and staffing issues, procedural prioritisation, viral transmission risk intraoperatively, changes to perioperative practice and ways of working alongside the impact on surgical education and training. Whilst there has been a growing literature base describing the early clinical course of COVID-19 and on aspects of critical care related to treating these patients, there has been a dearth of evidence on how this pandemic will affect surgical practice. This paper seeks to review the current evidence and offers recommendations for changes to surgical practice to minimise the effect of the COVID-19 pandemic.
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Affiliation(s)
- Ahmed Al-Jabir
- GKT School of Medical Education, King's College London, United Kingdom.
| | - Ahmed Kerwan
- GKT School of Medical Education, King's College London, United Kingdom
| | - Maria Nicola
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Zaid Alsafi
- UCL Medical School, University College London, United Kingdom
| | - Mehdi Khan
- UCL Medical School, University College London, United Kingdom
| | - Catrin Sohrabi
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
| | - Niamh O'Neill
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
| | - Christos Iosifidis
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, United Kingdom
| | | | - Ginimol Mathew
- UCL Medical School, University College London, United Kingdom
| | - Riaz Agha
- Barts Health NHS Trust, London, United Kingdom
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Maheshwari K, Hindocha S, Yousif A. Virtual clinics: Need of the hour, a way forward in the future. Adapting practice during a healthcare crisis. J Plast Reconstr Aesthet Surg 2020; 73:1357-1404. [PMID: 32426029 PMCID: PMC7230143 DOI: 10.1016/j.bjps.2020.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/09/2020] [Indexed: 11/28/2022]
Affiliation(s)
- K Maheshwari
- Dept. of Plastic surgery, Bedford Hospital NHS trust, Kempston road MK42 9DJ, United Kingdom
| | - S Hindocha
- Dept. of Plastic surgery, Bedford Hospital NHS trust, Kempston road MK42 9DJ, United Kingdom
| | - A Yousif
- Dept. of Plastic surgery, Bedford Hospital NHS trust, Kempston road MK42 9DJ, United Kingdom.
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9
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Govil D, Dhankhar D, Gupta R, Kumar S. Gastrointestinal cancer surgery during COVID times. APOLLO MEDICINE 2020. [DOI: 10.4103/am.am_79_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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10
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Connor MJ, Miah S, Edison MA, Brittain J, Smith MK, Hanna M, El-Husseiny T, Dasgupta R. Clinical, fiscal and environmental benefits of a specialist-led virtual ureteric colic clinic: a prospective study. BJU Int 2019; 124:1034-1039. [DOI: 10.1111/bju.14847] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Martin J. Connor
- Division of Surgery; Department of Surgery and Cancer; Imperial College London; London UK
- Department of Urology; Imperial College Healthcare NHS Trust; Charing Cross Hospital; London UK
| | - Saiful Miah
- Department of Urology; Imperial College Healthcare NHS Trust; Charing Cross Hospital; London UK
| | - Marie Alexandra Edison
- Department of Urology; Imperial College Healthcare NHS Trust; Charing Cross Hospital; London UK
| | - James Brittain
- Department of Urology; Imperial College Healthcare NHS Trust; Charing Cross Hospital; London UK
| | - Mitra Kondjin Smith
- Department of Urology; Imperial College Healthcare NHS Trust; Charing Cross Hospital; London UK
| | - Milad Hanna
- Department of Urology; Imperial College Healthcare NHS Trust; Charing Cross Hospital; London UK
| | - Tamer El-Husseiny
- Department of Urology; Imperial College Healthcare NHS Trust; Charing Cross Hospital; London UK
| | - Ranan Dasgupta
- Department of Urology; Imperial College Healthcare NHS Trust; Charing Cross Hospital; London UK
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11
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Miah S, Dunford C, Edison M, Eldred-Evans D, Gan C, Shah TT, Lunn P, Winkler M, Ahmed HU, Gibbons N, Hrouda D. A prospective clinical, cost and environmental analysis of a clinician-led virtual urology clinic. Ann R Coll Surg Engl 2019; 101:30-34. [PMID: 30286648 PMCID: PMC6303818 DOI: 10.1308/rcsann.2018.0151] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2018] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION A virtual clinic is a form of telemedicine where contact between clinical teams and patients occur without face-to-face consultation. Our study aims to quantify the clinical, financial and environmental benefits of our virtual urology clinic. MATERIAL AND METHODS We collected data prospectively from our weekly follow-up virtual clinic over a continuous four-month period between July and September 2017. RESULTS In total, we reviewed 409 patients. Following virtual clinic consultation, 68.5% of our patients were discharged from further follow-up. The majority of our patients (male 57.7%, female 55.5%) were of working age. The satisfaction scores were high, at 90.1%, and there were no reported adverse events as a result of using the virtual clinic. Our calculated cost savings were £18,744, with a predicted 12-month cost saving of £56,232. The creation of additional face-to-face clinic capacity has created an estimated 12-month increase in tariff generation for our unit of £72,072. In total, 4623 travel miles were avoided by patients using the virtual clinic, with an estimated avoided carbon footprint of 0.35-1.45 metric tonnes of CO2e, depending on mode of transport. Our predicted 12-month avoided carbon footprint is 1.04-4.04 metric tonnes of CO2e. CONCLUSIONS Our virtual clinic model has demonstrated a trifecta of positive outcomes, namely, clinical, financial and environmental benefits. The environmental importance and benefits of a virtual clinic should be promoted as a social enterprise value when engaging stakeholders in setting up such a urological service. We propose the adoption of our virtual clinic model in those urological units considering this method of telemedicine.
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Affiliation(s)
- S Miah
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
- Division of Surgery and Interventional Science, University College London, London, UK
- Both are first joint authors
| | - C Dunford
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
- Both are first joint authors
| | - M Edison
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - D Eldred-Evans
- Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - C Gan
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - TT Shah
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
- Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - P Lunn
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - M Winkler
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - HU Ahmed
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
- Division of Surgery, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
| | - N Gibbons
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
| | - D Hrouda
- Department of Urology, Imperial Healthcare NHS Trust, Charing Cross Hospital, London, UK
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