1
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Shomorony A, Weitzman R, Chen YH, Liao D, Sclafani AP. Augmented Virtual Examination for Cosmetic and Functional Rhinoplasty. Facial Plast Surg Aesthet Med 2024; 26:65-70. [PMID: 37358622 DOI: 10.1089/fpsam.2023.0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Abstract
Background: Few studies have critically evaluated the quality of data obtained during telemedical evaluations of patients with nasal complaints. Objective: To compare the quality of data provided by remote endoscopic and external nasal examination with those by in-person evaluations for rhinoplasty and functional nasal surgery, measured by detectability of anatomic features, and to assess associated patient experience measured by reported ease, discomfort, and likelihood of peer recommendation. Materials and Methods: Twenty healthy subjects performed a nasal self-examination using an endoscope and webcam under remote videoconferencing service (VCS) guidance. They subsequently underwent in-person examination and were surveyed about their experience. Inter-rater reliability was calculated using kappa coefficients. Detectability of anatomic features by in-person versus virtual examination was compared using Wilcoxon and chi-square tests. Results: Median subject age was 27.5 years (range 23-77). Kappa coefficients were 0.78 for in-person and 0.66 for virtual evaluations. Only the internal nasal valve and inferior turbinate were better visualized in person. There were no differences between detectability of external features on in-person versus virtual examinations. Subjects' average likelihood of recommending this technology (1-10) was 8.65 (SD 1.4). Conclusions: Intranasal examination by physician-guided remote endoscopy and webcam-based facial analysis demonstrate nasal anatomy comparable with in-person evaluation and anterior rhinoscopy.
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Affiliation(s)
- Andre Shomorony
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Rachel Weitzman
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Yu Han Chen
- Weill Cornell Medical College, New York, New York, USA
| | - David Liao
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, New York, USA
| | - Anthony P Sclafani
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, New York, USA
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2
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Shomorony A, Weitzman R, Chen H, Sclafani AP. Augmented otorhinologic evaluation in telemedical visits. Am J Otolaryngol 2024; 45:104088. [PMID: 37832329 DOI: 10.1016/j.amjoto.2023.104088] [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: 08/25/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023]
Abstract
PURPOSE To determine if an endoscopic otologic and rhinologic examination performed by a patient and interpreted remotely by an otolaryngologist is non-inferior to in-person examination, and to assess the feasibility of this system for telemedical visits. MATERIALS AND METHODS Twenty healthy subjects performed a self-examination of their ears and nose using a commercially available endoscope under remote guidance by an otolaryngology provider over Zoom. This same provider and another otolaryngologist also performed separate, in-person examinations of each subject and rated their findings. Finally, both providers blindly reviewed a video recording of each virtual exam four weeks later and rated their findings. Subjects were surveyed about their experience. Interrater reliability was calculated using Cohen's kappa coefficients and the ability to detect different anatomic structures and features by in-person vs. virtual examination was compared using Wilcoxon tests and Chi-squared proportion tests. RESULTS The subjects' average age was 30 (SD 11.5) years. Interrater reliability was excellent; kappa coefficients were 0.72 and 0.81 (p < 0.001) for virtual and in-person exams, respectively. Of the 3 anatomic structures within the ear exam, none showed a difference in detectability between virtual and in-person exams. Of the 12 structures in the nasal exam, 3 were better visualized in-person and 9 showed no difference. Subject satisfaction was excellent; the average likelihood of recommending this virtual technology to peers (1-10) was 8.65 (SD 1.4). CONCLUSIONS Patient self-examination of the ears and nose using a portable endoscope may be an effective strategy for obtaining valuable data during telemedical otolaryngology visits.
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Affiliation(s)
- Andre Shomorony
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY, USA.
| | - Rachel Weitzman
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY, USA
| | - Hannah Chen
- Weill Cornell Medical College, New York, NY, USA
| | - Anthony P Sclafani
- Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, NY, USA
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3
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Montalbaron MB, Achlatis E, Johnson AM, Ma Y, Young VN, Rosen CA, Amin MR, Kwak PE. Presumptive Diagnosis in Tele-Health Laryngology: A Multi-Center Observational Study. Ann Otol Rhinol Laryngol 2023; 132:1511-1519. [PMID: 37070580 DOI: 10.1177/00034894231165811] [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] [Indexed: 04/19/2023]
Abstract
OBJECTIVES Early in the COVID-19 pandemic, outpatient visits were adapted for the virtual setting, forcing laryngologists to presume certain diagnoses without the aid of laryngoscopy, solely based on history and the limited physical exam available via video visit. This study aims to examine the accuracy of presumptive diagnoses made via telemedicine, compared to subsequent in-person follow up, where endoscopic examination could confirm or refute suspected diagnoses. METHODS A retrospective chart review was conducted of 38 patients evaluated for voice-related issues at NYU Langone Health and the University of California-San Francisco. Presumptive diagnoses at the initial telemedicine encounter were noted, along with diagnostic cues used for clinical reasoning and recommended treatment plans. These presumptive diagnoses were compared to diagnoses and plans established following laryngoscopy at follow-up in-person visits. RESULTS After laryngoscopy at the first in-person visit, 38% of presumptive diagnoses changed, as did 37% of treatment plans. The accuracy varied among conditions. Muscle tension dysphonia and Reinke's edema were accurately diagnosed without laryngoscopy, but other conditions, including vocal fold paralysis and subglottic stenosis, were not initially suspected, relying on laryngoscopy for diagnosis. CONCLUSIONS While some laryngologic conditions may be reasonably identified without in-person examination, laryngoscopy remains central to definitive diagnosis and treatment. Telemedicine can increase access to care, but it may provide more utility as a screening tool, triaging which patients should present more urgently for in-person laryngoscopy. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- Michael B Montalbaron
- NYU Voice Center, Department of Otolaryngology - Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Efstratios Achlatis
- NYU Voice Center, Department of Otolaryngology - Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Aaron M Johnson
- NYU Voice Center, Department of Otolaryngology - Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Yue Ma
- UCSF Voice and Swallowing Center, Department of Otolaryngology - Head and Neck Surgery, University of California San Francisco, San Francisco, CA, USA
| | - VyVy N Young
- UCSF Voice and Swallowing Center, Department of Otolaryngology - Head and Neck Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Clark A Rosen
- UCSF Voice and Swallowing Center, Department of Otolaryngology - Head and Neck Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Milan R Amin
- NYU Voice Center, Department of Otolaryngology - Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
| | - Paul E Kwak
- NYU Voice Center, Department of Otolaryngology - Head and Neck Surgery, New York University Grossman School of Medicine, New York, NY, USA
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Anthony Jnr B. Investigating the implementation of telehealth and digital technologies during public health crisis: A qualitative review. Int J Health Plann Manage 2023; 38:1212-1227. [PMID: 37452470 DOI: 10.1002/hpm.3681] [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: 07/01/2020] [Revised: 12/23/2022] [Accepted: 07/07/2023] [Indexed: 07/18/2023] Open
Abstract
Public health crises such as the Coronavirus disease 2019 (COVID-19) pandemic across the world overstrained the health care system. Accordingly, telehealth and digital technologies were implemented. Telehealth and digital technologies refer to the provision of health care at a distance using electronic means for diagnosis, evaluation, treatment, monitoring, and education of patients. This approach, while extremely useful, can be challenging for both patients and physicians, mainly as this is a new mode of health care to health practitioners and patients. Intrinsically, when managing the massive disruption to the routine of patient health care workflow, it is important to understand the important factors associated with an accelerated introduction of telehealth and digital technologies for the effective and safe continuation of healthcare during a public health crisis. Accordingly, this current study performed a qualitative review analysis of 40 scientific sources from 2019 to 2022. Findings present health practitioners that implemented telehealth and digital technologies during the public health emergency. Additionally, findings from this study presents a workflow approach for telehealth visit cycle and also discusses the current telehealth and virtual applications being implemented during public health crisis. This study provides implications to support health care managers and policymakers of health centres to be virtually informed regarding digital applications being implemented by patients and health practitioners on how to implement an effective telehealth system during public health crises.
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Affiliation(s)
- Bokolo Anthony Jnr
- Department of Applied Data Science, Institute for Energy Technology, Halden, Norway
- Department of Computer Science and Communication, Østfold University College, Halden, Norway
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Ali Y, Khan HU. A Survey on harnessing the Applications of Mobile Computing in Healthcare during the COVID-19 Pandemic: Challenges and Solutions. COMPUTER NETWORKS 2023; 224:109605. [PMID: 36776582 PMCID: PMC9894776 DOI: 10.1016/j.comnet.2023.109605] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 11/17/2022] [Accepted: 01/31/2023] [Indexed: 06/18/2023]
Abstract
The COVID-19 pandemic ravaged almost every walk of life but it triggered many challenges for the healthcare system, globally. Different cutting-edge technologies such as Internet of things (IoT), machine learning, Virtual Reality (VR), Big data, Blockchain etc. have been adopted to cope with this menace. In this regard, various surveys have been conducted to highlight the importance of these technologies. However, among these technologies, the role of mobile computing is of paramount importance which is not found in the existing literature. Hence, this survey in mainly targeted to highlight the significant role of mobile computing in alleviating the impacts of COVID-19 in healthcare sector. The major applications of mobile computing such as software-based solutions, hardware-based solutions and wireless communication-based support for diagnosis, prevention, self-symptom reporting, contact tracing, social distancing, telemedicine and treatment related to coronavirus are discussed in detailed and comprehensive fashion. A state-of-the-art work is presented to identify the challenges along with possible solutions in adoption of mobile computing with respect to COVID-19 pandemic. Hopefully, this research will help the researchers, policymakers and healthcare professionals to understand the current research gaps and future research directions in this domain. To the best level of our knowledge, this is the first survey of its type to address the COVID-19 pandemic by exploring the holistic contribution of mobile computing technologies in healthcare area.
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Affiliation(s)
- Yasir Ali
- Higher Education Department, Khyber Pakhtunkhwa, Government Degree College Kotha Swabi, KP, Pakistan
- Higher Education Department, Shahzeb Shaheed Government Degree College Razzar, Swabi, KP, Pakistan
| | - Habib Ullah Khan
- Accounting and Information, College of Business and Economics, Qatar University, Doha Qatar
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Al Salman A, Fatehi A, Crijns TJ, Ring D, Doornberg JN. Surgeon preferences are associated with utilization of telehealth in fracture care. Eur J Trauma Emerg Surg 2023; 49:261-272. [PMID: 35882636 PMCID: PMC9323880 DOI: 10.1007/s00068-022-02065-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 06/30/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The SARS-CoV-2 (COVID-19) pandemic has the potential to evoke lasting changes in the delivery of care, and the utilization of telehealth. We sought associations between surgeon personal factors and greater use of telehealth to treat fractures relative to in-person care. METHODS Seventy-five fracture surgeons participated in a survey-based experiment. All surgeons were asked about their preferences regarding remote compared to in-person communication. Participants rated the following items on slider scales: their degree of introversion, the importance of a hands-on/physical exam and surgeon preferences regarding telehealth. We identified factors associated with the use of, and comfort with, telehealth. RESULTS The use of telehealth during the pandemic was associated with comfort evaluating wounds via telehealth. A greater proportion of remote visits was associated with comfort evaluating wounds and confidence teaching exercises via telehealth. There was consensus that telehealth did not alter utilization rates of radiographs or offer of discretionary surgery. The use of absorbable sutures to limit in-person visits was associated with a preference for working from home and greater comfort with evaluating wounds remotely. The use of 2- and 6-week post-operative telehealth visits and plans to use telehealth after the pandemic (52%) were associated with greater comfort in evaluating wounds through telehealth and greater confidence with video instruction of exercises. CONCLUSIONS The finding that personal factors are associated with utilization of telehealth helps target strategies for increased use of telehealth and other technologies as the pandemic wanes. Given that telehealth adds convenience for people with ambulatory difficulties or in remote areas, such efforts are warranted. LEVEL OF EVIDENCE Not applicable.
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Affiliation(s)
- Aresh Al Salman
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Health Discovery Building, MC Z0800, 1701 Trinity St., Austin, TX 78712 USA ,Department of Orthopaedic Surgery, Universitair Medisch Centrum Groningen, Rijksuniversiteit Groningen at Groningen, Groningen, The Netherlands
| | - Amirreza Fatehi
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Health Discovery Building, MC Z0800, 1701 Trinity St., Austin, TX 78712 USA
| | - Tom J. Crijns
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Health Discovery Building, MC Z0800, 1701 Trinity St., Austin, TX 78712 USA ,Department of Orthopaedic Surgery, Universitair Medisch Centrum Groningen, Rijksuniversiteit Groningen at Groningen, Groningen, The Netherlands
| | - David Ring
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Health Discovery Building, MC Z0800, 1701 Trinity St., Austin, TX, 78712, USA.
| | - Job N. Doornberg
- Department of Orthopaedic Surgery, Universitair Medisch Centrum Groningen, Rijksuniversiteit Groningen at Groningen, Groningen, The Netherlands
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7
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Koopirom P, Wiriyaamornchai P, Santeerapharp A. Telemedicine in Thai-otorhinolaryngology patients in COVID-19 situation; primary surveys. Digit Health 2022; 8:20552076221147795. [PMID: 36601287 PMCID: PMC9806494 DOI: 10.1177/20552076221147795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 12/08/2022] [Indexed: 12/28/2022] Open
Abstract
Introduction COVID-19 pandemic has put a strain on various aspects of hospital management due to high rates of infection and increased preventive measures around the world. Physicians and patients alike are susceptible to the ongoing virus causing concern leading to loss or postpone of follow up. Thailand has just start integration of digital solutions such as telemedicine which expected similar level of medical care and efficiency while reducing risk of exposure during the COVID-19 pandemic. Objective Evaluation the willingness to accept telemedicine in otorhinolaryngology patients during the peak COVID-19 outbreaks in our institution. Methods Collected data from all patients who had a schedule follow up for otorhinolaryngology department between the months of June to August, 2021 at out-patient Center. Results Total of 299 otorhinolaryngology patients included, 213 patients (71.2%) denied a virtual medical visit whereas 86 patients (28.8%) accepted. The obstructive sleep apnea (OSA) was the only group to have more acceptance of telemedicine, 79.5% than denying 20.5% with statistical significance (p < 0.01). Age difference between the accepting and declining group also showed statistical significance, 48.5 years and 56 years respectively (p < 0.01). Main Reasons for their decision, 48% of patients accepted due to experiencing clinical improvement and stability. The main reason for not accepting telemedicine was 80% of patients preferred a special otorhinolaryngologic examination on follow up. Conclusions This primary surveys among Thai otorhinolaryngology patients about telemedicine. The greater number of patients not interested in telemedicine due to requirement of otorhinolaryngologic examination. Which OSA follow-up patients have more attention in telemedicine.
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Affiliation(s)
| | | | - Alena Santeerapharp
- Alena Santeerapharp, Department of
Otolaryngology-Head & Neck Surgery, Faculty of Medicine, Srinakharinwirot
University, Bangkok, Thailand.
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8
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Tolvi M, Lahti T, Aaltonen LM. Otorhinolaryngology Virtual Visits During the COVID-19 Pandemic: A 2-Year Follow-Up Study. Telemed J E Health 2022; 29:665-673. [PMID: 36112177 DOI: 10.1089/tmj.2022.0305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Objective: To clarify how successful virtual visits were in different age groups and subspecialties of otorhinolaryngology during the COVID-19 pandemic, with a 2-year follow-up. Methods: We examined the progress of treatment and need for face-to-face follow-ups in a retrospective setting. Case records of all the visits marked as virtual between March and June 2020 in Helsinki University Hospital Department of Otorhinolaryngology-Head and Neck Surgery (ORL-HNS) were reviewed. Results: Among 865 virtual visits, 71.2% (n = 616) clearly advanced treatment, 53.8% (n = 465) needed no face-to-face follow-up, and only 9.0% (n = 78) were followed by an unplanned visit within 6 months. Statistically significant differences were detected among different subspecialties and age groups. Virtual visits achieved clear progress of treatment most frequently in laryngology (119/149 visits, 79.9%) and in head and neck surgery (69/83 visits, 83.1%). Laryngology patients required the least face-to-face follow-ups (n = 38 scheduled, 25.5% of laryngology visits). Most visits with clear progress involved 18-29-year-olds (n = 100, 80.0%) and they also required least face-to-face follow-ups (n = 39, 31.2%). During the 6-month to 2-year follow-up, 82 patients (9.6%) contacted our clinic directly for outpatient treatment, 28 patients (3.3%) called or visited the emergency department, and 37 patients (4.3%) were referred to the ORL-HNS clinic again for the same issue. Conclusion: Virtual visits were beneficial for treatment of otorhinolaryngology patients, and unplanned visits afterward were rare. Differences in effectiveness among subspecialties suggest that the utility of telemedicine applications can be enhanced by examining more closely which patient and ailment characteristics favor virtual visits.
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Affiliation(s)
- Morag Tolvi
- Department of Otorhinolaryngology—Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland
| | - Tiitu Lahti
- Department of Otorhinolaryngology—Head and Neck Surgery, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Leena-Maija Aaltonen
- Department of Otorhinolaryngology—Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland
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Al-Ani RM. Ear, nose, and throat manifestations of COVID-19 and its vaccines. World J Clin Cases 2022; 10:8808-8815. [PMID: 36157654 PMCID: PMC9477042 DOI: 10.12998/wjcc.v10.i25.8808] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/01/2022] [Accepted: 07/25/2022] [Indexed: 02/05/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a highly infectious disease and was designated a pandemic by the World Health Organization (WHO) on March 11, 2020. There are no classical manifestations of the disease. The most prevalent symptoms include fever, cough, dyspnea, myalgia and headache. The main route of transmission of the severe acute respiratory syndrome coronavirus-2 is through the upper respiratory tract. Therefore, it is not strange to find different ear, nose and throat (ENT) symptoms in individuals infected with this virus. Olfactory dysfunction is a common feature of COVID-19; either it is the only presenting symptom or it accompanies other manifestations of the disease. Other otolaryngological features such as sudden sensorineural hearing loss (SSNHL), dysphonia, nasal obstruction, sore throat, etc. are less frequent manifestations of COVID-19. These features, in addition, to being presented early in the disease process, certain long-standing symptoms like parosmia, dysphonia, and persistent deafness, are other characteristics of the disease. Geographical variation in otorhinolaryngological prevalence is another problem with this debilitating disease. Local and systemic adverse effects (local site injection pain, fever, myalgia, headache, and others) of the COVID-19 vaccines are more frequent than otolaryngological side effects (anosmia, hyposmia, Bell’s palsy, SSNHL, etc.). We aimed in this review to summarize the early and persistent ENT symptoms of COVID-19 or after the various COVID-19 vaccines.
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Affiliation(s)
- Raid M Al-Ani
- Department of Surgery/Otolaryngology, University of Anbar, College of Medicine, Ramadi 31001, Anbar, Iraq
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10
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Choi JS, Lin M, Park S, Abdur-Rahman F, Kim JH, Voelker CCJ. Physician satisfaction with telemedicine and in-person visits in otolaryngology. Am J Otolaryngol 2022; 43:103596. [PMID: 35969912 DOI: 10.1016/j.amjoto.2022.103596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 08/07/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVES To investigate the differential factors associated with physician satisfaction between telemedicine and in-person visits in otolaryngology. METHODS Study data included 646 telemedicine and 365 in-person encounters delivered from May-June 2020 at a tertiary center outpatient setting. Encounter-specific physician satisfaction was rated by 15 otolaryngologists using Provider Satisfaction Questionnaire (range 0-100) consisted of 5 items (patient needs addressed, patient involvement, adequacy of information given, quality of emotion support provided, and general interaction satisfaction). A multivariable linear mixed-effects model was used to explore patient demographic and clinical factors associated with physician satisfaction. RESULTS Physician satisfaction scores for telemedicine and in-person visits were 83.0 [95 % CI: 77.0-88.9] and 88.1 [95 % CI: 82.5-93.6], respectively. Among telemedicine visits, physician satisfaction scores were significantly higher for follow-up (vs. new), videoconference (vs. telephone) encounters, and English-speaking patients in a multivariable model. New encounters had significantly lower satisfaction subdomain scores for adequacy of information given to the patient (β = -4.7 [95 % CI: -7.3 to -2.0], p = 0.001) and addressing the needs of the patient among telemedicine visits (β = -4.1, [95 % CI: -7.1 to -1.1], p = 0.007) while there were no differences in satisfaction scores between new vs follow-up visits among in-person visits. For non-English speaking patients, the physician satisfaction scores were significantly lower for subdomain scores assessing active patient participation (β = -13.1, [95 % CI: -13.1 to -17.4], p < 0.001) and emotional support given to the patient (β = -7.8, [95 % CI: -11.0 to -4.5], p < 0.001) for telemedicine visits. CONCLUSIONS Telemedicine has been broadly adopted as an alternative option to deliver care in otolaryngology since COVID-19 pandemic. Appropriate triaging based on patient and encounter characteristics may enhance physician satisfaction and overall experiences with telemedicine. Further efforts are needed to provide adequate interpretation and videoconference services during telemedicine visits.
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Affiliation(s)
- Janet S Choi
- Department of Otolaryngology-Head & Neck Surgery, University of Minnesota, Minneapolis, MN, USA.
| | - Matthew Lin
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Soyun Park
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Faiz Abdur-Rahman
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - James H Kim
- Caruso Department of Otolaryngology-Head & Neck Surgery, Keck, School of Medicine of the University of Southern California, Los Angeles, CA, USA
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11
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Al Salman A, Doornberg JN, Ring D, Crijns TJ. Surgeon Personal Factors Associated with Care Strategies in Musculoskeletal Telehealth. THE ARCHIVES OF BONE AND JOINT SURGERY 2022; 10:543-560. [PMID: 36032635 PMCID: PMC9382251 DOI: 10.22038/abjs.2021.55263.2752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 11/03/2021] [Indexed: 06/15/2023]
Abstract
BACKGROUND Most surgeons used, or are currently using telehealth during the SARS-CoV-2 (COVID-19) pandemic. We studied surgeon personal factors associated with relative use of telehealth during the worldwide height of the pandemic. Questions/Purposes: (1) Are there any personal factors/characteristics associated with use and utilization of telehealth? (2) What are surgeon's perspectives/ opinions with regard to use of telehealth for five common upper extremity conditions in terms of future prospects and viability? METHODS Hand and upper extremity surgeons in the Science of Variation Group (SOVG) were invited to participate in a web-based survey. The first part of the survey focused on surgeon characteristics and work preferences. The second part focused on care strategies during the pandemic and utilization of telehealth. The final part of the survey addressed the care of five common upper extremity conditions during the pandemic. RESULTS Ninety percent of surgeons used telehealth during the first few months of the pandemic, but only 20% of visits were virtual. A greater percentage of telehealth visits compared to office visits was independently associated with a policy of only seeing people with emergencies in person (RC: 0.64; CI 95%: 0.21 to 1.1; P<0.01). Surgeons found it difficult to reproduce most parts of the physical examination on video, but relatively easy to make a diagnosis, with both ratings associated with less belief that the physical exam is essential. Comfort in offering surgery by video visit was associated with having young children, preference for remote meetings, and less belief that the physical exam is essential. CONCLUSION Utilization of, and comfort with, telehealth is related to personal factors and preferences, acceptance of a more limited physical examination in particular. Utilization of early adopters and training to increase comfort with the probabilistic aspects of medicine could facilitate incorporation of telehealth into standard practice.
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Affiliation(s)
- Aresh Al Salman
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Job N. Doornberg
- Department of Orthopaedic Surgery, Universitair Medisch Centrum Groningen, Rijksuniversiteit Groningen at Groningen, The Netherlands
| | - David Ring
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
| | - Tom J. Crijns
- Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas at Austin, Austin, TX, USA
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12
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Elzayat S, Elfarargy HH, Mandour M, Mahrous A, El-Deeb ME, Barbara M, Elsherief H. The Impact of COVID-19 on the Daily Life and Medical Practice of Otolaryngology Physicians. Int Arch Otorhinolaryngol 2022; 26:e478-e486. [PMID: 35846808 PMCID: PMC9282957 DOI: 10.1055/s-0042-1745854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 03/01/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction
The coronavirus disease 2019 (COVID-19) has made otolaryngologists more susceptible than their counterparts to its effect.
Objective
This study aimed to find if COVID-19 had a different impact on ear, nose, and throat (ENT) physicians' of various categories (residents, registrars, and consultants ) regarding many aspects of the quality of life (protection, training, financial, and psychological aspects).
Methods
We included 375 ENT physicians, of different categories (residents, registrars, and consultants), from 33 general hospitals and 26 university hospitals in Egypt. The study was conducted using a 20-item questionnaire with a response scale consisting of three categories: yes, no, and not sure. It covered infection control and personal protective equipment (PPE) usage; medical practice and safety; online consultation and telemedicine,; webinars and online lectures; COVID-19 psychological, financial, and quarantine period effects; and future expectations.
Results
The results of the questionnaire showed that COVID-19 had a statistically significant impact on the daily life of the responders. There were statistically significant differences among the three involved categories, based on their answers.
Conclusion
This study showed a statistically significant difference regarding the impact of COVID-19 on many aspects of the quality of life (protection, training, financial, and psychological aspects) of ENT physicians of various categories (residents, registrars, and consultants), and these effects may persist for a long time.
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Affiliation(s)
- Saad Elzayat
- Faculty of Medicine, Department of Otorhinolaryngology, Kafrelsheikh University, Egypt
| | - Haitham H Elfarargy
- Faculty of Medicine, Department of Otorhinolaryngology, Kafrelsheikh University, Egypt
| | - Mahmoud Mandour
- Faculty of Medicine, Department of Otolaryngology, Tanta University, Egypt
| | - Ali Mahrous
- Faculty of Medicine, Department of Otorhinolaryngology, Al-Azhar University, Egypt
| | - Mohamed E El-Deeb
- Faculty of Medicine, Department of Otorhinolaryngology, Kafrelsheikh University, Egypt
| | - Maurizio Barbara
- Faculty of Medicine, Department of Otolaryngology, Sapienza Roma University, Italy
| | - Hossam Elsherief
- Faculty of Medicine, Department of Otolaryngology, Tanta University, Egypt
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13
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Rahman MM, Khatun F, Sami SI, Uzzaman A. The evolving roles and impacts of 5G enabled technologies in healthcare: The world epidemic COVID-19 issues. ARRAY 2022; 14:100178. [PMID: 35571870 PMCID: PMC9085442 DOI: 10.1016/j.array.2022.100178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 04/25/2022] [Indexed: 11/26/2022] Open
Abstract
The latest 5G technology is being introduced the Internet of Things (IoT) Era. The study aims to focus the 5G technology and the current healthcare challenges as well as to highlight 5G based solutions that can handle the COVID-19 issues in different arenas. This paper provides a comprehensive review of 5G technology with the integration of other digital technologies (like AI and machine learning, IoT objects, big data analytics, cloud computing, robotic technology, and other digital platforms) in emerging healthcare applications. From the literature, it is clear that the promising aspects of 5G (such as super-high speed, high throughput, low latency) have a prospect in healthcare advancement. Now healthcare is being adopted 5G-based technologies to aid improved health services, more effective medical research, enhanced quality of life, better experiences of medical professionals and patients in anywhere–anytime. This paper emphasizes the evolving roles of 5G technology for handling the epidemiological challenges. The study also discusses various technological challenges and prospective for developing 5G powered healthcare solutions. Further works will incorporate more studies on how to expand 5G-based digital society as well as to resolve the issues of safety–security–privacy and availability–accessibility–integrity in future health crises.
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Affiliation(s)
- Md Mijanur Rahman
- Department of Computer Science and Engineering, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh 2224, Bangladesh
| | - Fatema Khatun
- Department of Electrical and Electronic Engineering, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj 8100, Bangladesh
| | - Sadia Islam Sami
- Department of Computer Science and Engineering, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh 2224, Bangladesh
| | - Ashik Uzzaman
- Department of Computer Science and Engineering, Jatiya Kabi Kazi Nazrul Islam University, Trishal, Mymensingh 2224, Bangladesh
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Mehraeen E, Mehrtak M, SeyedAlinaghi S, Nazeri Z, Afsahi AM, Behnezhad F, Vahedi F, Barzegary A, Karimi A, Mehrabi N, Dadras O, Jahanfar S. Technology in the Era of COVID-19: A Systematic Review of Current Evidence. Infect Disord Drug Targets 2022; 22:e240322202551. [PMID: 35331123 DOI: 10.2174/1871526522666220324090245] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/13/2021] [Accepted: 11/01/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, the use of technology-based services has been incremental by the care providers for patients scheduling, regulatory considerations, resource allocation, thus enabling virus exposure prevention while maintaining effective patient care. This study aims to review the currently available evidence to identify available technology solutions in the era of COVID-19. METHODS A systematic review in July 2020 using the PubMed, Scopus, Embase, Science Direct, and Web of Science databases has been carried out. After evaluating the title and abstract to select the most relevant studies based on inclusion and exclusion criteria, the selected articles underwent quality assessment. The full text of selected articles was then thoroughly evaluated to extract the essential findings. RESULTS In this study, 20 technology-based approaches have been identified for provision of healthcare services to patients with COVID-19. These methods included telemedicine, virtual visits, e-consult, tele-consulting, video conference, virtual healthcare, mobile-based self-care, social media, tele ICU, 3D printing technology, telemonitoring, teleradiology, telesurgical, and cloud-based service. CONCLUSION Due to the rapid spread of the coronavirus, the use of technology-based methods for the provision of remote healthcare services can help control the disease. The effectiveness of each of these approaches can be investigated in future research.
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Affiliation(s)
- Esmaeil Mehraeen
- Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran
| | - Mohammad Mehrtak
- School of Medicine and Allied Medical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Nazeri
- Department of Medical Informatics, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Masoud Afsahi
- Department of Radiology,School of Medicine,University of California, San Diego (UCSD), California, USA
| | - Farzane Behnezhad
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzin Vahedi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Amirali Karimi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Mehrabi
- Department of Health Information Technology, Aja University of Medical Sciences, Tehran, Iran
| | - Omid Dadras
- School of Public Health, Walailak University, Nakhon Si Thammarat, Thailand
| | - Shayesteh Jahanfar
- Department of Public Health and Community Medicine, Tufts University School of Medicine, USA
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15
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Shilo S, Ungar OJ, Handzel O, Abu Eta R, Shapira U, Muhanna N, Oron Y. Telemedicine for Patients With Unilateral Sudden Hearing Loss in the COVID-19 Era. JAMA Otolaryngol Head Neck Surg 2022; 148:166-172. [PMID: 34940804 PMCID: PMC8704165 DOI: 10.1001/jamaoto.2021.3672] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Importance Developing a telemedicine tool to discriminate between patients who need urgent treatment for sudden sensorineural hearing loss (SSNHL) from those who do not takes on special importance during the COVID-19 pandemic. Objective To explore the feasibility of a telemedicine model to assist in the evaluation of new-onset unilateral sudden hearing loss (SHL) among patients who do not have access to medical resources, especially during the COVID-19 pandemic. Design, Setting, and Participants This prospective cohort investigation of a telemedicine model was conducted at a tertiary referral medical center between May 2020 and January 2021, with the interpreting physician blinded to the results of formal audiograms. The study included a consecutive sample of adult patients (aged ≥18 years) referred to the otolaryngology emergency department in our medical center with the chief complaint of new-onset unilateral SHL. Interventions The telemedicine model comprised 2 sequential steps: a Weber test using the Hum Test and a smartphone-based vibration, and uHear app-based audiometry. Main Outcomes and Measures Discrimination between patients with and without SSNHL by using the telemedicine model. All diagnoses subsequently confirmed by a formal audiogram. Results Fifty-one patients with new-onset unilateral SHL participated in the study study (median age, 45 [range, 18-76] years; 28 [54.9%] men). The sensitivity and specificity of the telemedicine model for fulfilling the audiometric criteria of SSNHL (loss of ≥30 dB in ≥3 consecutive frequencies) were 100% (95% CI, 84%-100%) and 73% (95% CI, 54%-88%), respectively. The PPV was 72% (95% CI, 53%-87%), the NPV was 100% (95% CI, 85%-100%), and the accuracy was 84.3% (95% CI, 71%-93%). Although 8 participants had false-positive results, all of them had SSNHL that did not meet the full audiometric criteria. Conclusions and Relevance The telemedicine model presented in this study for the diagnosis of SSNHL is valid and reliable. It may serve as a primary tool for the discrimination between patients in need of urgent care for SSNHL from those who are not, especially during the COVID-19 pandemic.
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Affiliation(s)
- Shahaf Shilo
- Department of Otolaryngology–Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Omer J. Ungar
- Department of Otolaryngology–Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ophir Handzel
- Department of Otolaryngology–Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rani Abu Eta
- Department of Otolaryngology–Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Udi Shapira
- Department of Otolaryngology–Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nidal Muhanna
- Department of Otolaryngology–Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yahav Oron
- Department of Otolaryngology–Head and Neck Surgery and Maxillofacial Surgery, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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16
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Ohlstein JF, Ahmed OG, Garner J, Takashima M. Telemedicine in Otolaryngology in the COVID-19 Era: A Year Out. Cureus 2021; 13:e20794. [PMID: 35111474 PMCID: PMC8794398 DOI: 10.7759/cureus.20794] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2021] [Indexed: 02/07/2023] Open
Abstract
One year ago, shortly after the onset of the coronavirus disease 2019 (COVID-19) pandemic, we published our initial experience with telemedicine. We showed that during the early pandemic, there was a dramatic shift to telemedicine and that 70% of our patients would decline telemedicine in favor of an in-person visit. As clinical limitations and stay-at-home orders relaxed, we sought to define how we have used telemedicine since. After the initial month of the pandemic, our utilization of telemedicine fell to an average of only 5% of visits over the past year. Nearly 80% of all telemedicine visits were routine follow-up visits, with its usage being unaffected by local policy and pandemic surges. The usefulness and applications of telemedicine have been well described; however, after our initial reliance on telemedicine, its use has been minimal. Moving forward, attention will need to focus on innovation and expanding comprehensive virtual examinations for otolaryngology to fully embrace this technology.
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Affiliation(s)
- Jason F Ohlstein
- Department of Otolaryngology - Head and Neck Surgery, St. Luke's University Hospital, Bethlehem, USA.,Department of Otolaryngology - Head and Neck Surgery, Houston Methodist Hospital, Houston, USA
| | - Omar G Ahmed
- Department of Otolaryngology - Head and Neck Surgery, Houston Methodist Hospital, Houston, USA
| | - Jordan Garner
- Department of Otolaryngology - Head and Neck Surgery, Houston Methodist Hospital, Houston, USA
| | - Masayoshi Takashima
- Department of Otolaryngology - Head and Neck Surgery, Houston Methodist Hospital, Houston, USA
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17
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Smedbäck J, Ilicki J, Perdahl T, Djärv T. Telemedicine for otolaryngological assessments. Am J Otolaryngol 2021; 42:103172. [PMID: 34391599 DOI: 10.1016/j.amjoto.2021.103172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 06/13/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | - Jonathan Ilicki
- Platform24 Healthcare, Västra Järnvägsgatan 7, 111 64 Stockholm, Sweden.
| | - Tobias Perdahl
- Platform24 Healthcare, Västra Järnvägsgatan 7, 111 64 Stockholm, Sweden.
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18
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Shahrul AI, Abd Rahman ANA. Telemedicine as an Alternative Way to Provide Multidisciplinary Cleft Care During the COVID-19 Pandemic. Open Dent J 2021. [DOI: 10.2174/1874210602115010446] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The current coronavirus pandemic is changing the way healthcare professionals provide services to patients. Healthcare professionals are required to provide quality care while reducing the risk of viral transmission. This pandemic has disrupted the timely multidisciplinary team care for patients with clefts across the globe. Thus, telemedicine has been recognized and accepted by various medical and dental specialists as a viable alternative to face-to-face consultation. In addition, telemedicine incorporating a digital workflow in cleft management will further reduce the risk of viral transmission and enhance the quality of treatment being provided to these patients.
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19
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Eligibility for live, interactive otolaryngology telemedicine: 19-month experience before and during the COVID-19 pandemic in Taiwan. Biomed J 2021; 44:582-588. [PMID: 34371224 PMCID: PMC8556875 DOI: 10.1016/j.bj.2021.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 07/19/2021] [Accepted: 07/29/2021] [Indexed: 01/27/2023] Open
Abstract
Background Unequal access to healthcare is a global medical problem. Telemedicine, recently made possible by technological advances, may mitigate this inequity. However, the usefulness of telemedicine for procedure-driven disciplines, such as otolaryngology, under infectious conditions (e.g., the COVID-19 pandemic) is unknown. Methods Telemedicine was made legal in Taiwan by an amendment to the Physician Act in 2018. Kaohsiung Chang Gung Memorial Hospital was the first hospital in Taiwan to provide the telemedicine service by connecting to the Chenggong Branch of Taitung Hospital (CGBTH) in November 2018. This retrospective cohort study included all new and established otolaryngology outpatient consultations between November 2018 and May 2020 at CGBTH. The Current Procedural Terminology and International Classification of Disease, 10th Revision codes, patient demographic data, and questionnaire data were obtained. Results The study included 123 patients with 218 encounters over 19 months. The majority of complaints were ear-related (52.6%). Overall, 49% of the encounters required a specialized procedure for diagnosis and treatment; of these, cerumen removal was the most common procedure. The patient subjective improvement rate increased over the study period (from 62.0% to 78.9%). The rates of return and case closure were both around 90% in 2018 and 2019. The number of otolaryngology consultations and rate of return declined after the start of the COVID-19 pandemic; however, the subjective improvement and case closure rates remained stable. The telemedicine service saved at least 2 h driving time per visit. Conclusion Telemedicine for otolaryngology is a promising approach for remote and underserved regions, as well as during an infectious disease pandemic.
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20
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Morisada MV, Tollefson TT, Shaye DA, Steele TO. The digital doctor: telemedicine in facial plastic surgery. Curr Opin Otolaryngol Head Neck Surg 2021; 29:271-276. [PMID: 34039841 DOI: 10.1097/moo.0000000000000722] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE OF REVIEW In the setting of the COVID-19 global pandemic, the demand for and use of telemedicine has surged in facial plastic and reconstructive surgery. This review aims to objectively review and summarize the existing evidence for the use of telemedicine within facial plastic surgery. RECENT FINDINGS Telemedicine has been successfully implemented among subsets of facial plastic surgery patients, with high patient and provider satisfaction. Although the technology to facilitate telemedicine exists and preliminary studies demonstrate promise, multiple technological, financial, and medical barriers may persist in the postpandemic era. SUMMARY Telemedicine will likely continue to grow and expand within facial plastic surgery moving forward, and we should continue to critically evaluate patient selection, access to care, and strategies for effective implementation to enhance current clinical practices.
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Affiliation(s)
- Megan V Morisada
- Department of Otolaryngology - Head and Neck Surgery, University of California Davis, Sacramento, California
| | - Travis T Tollefson
- Department of Otolaryngology - Head and Neck Surgery, University of California Davis, Sacramento, California
| | - David A Shaye
- Department of Otolaryngology - Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts
| | - Toby O Steele
- Department of Otolaryngology - Head and Neck Surgery, University of California Davis, Sacramento, California
- Northern California Healthcare System, Sacramento, California, USA
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21
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Thong HK, Wong DKC, Gendeh HS, Saim L, Athar PPBSH, Saim A. Perception of telemedicine among medical practitioners in Malaysia during COVID-19. J Med Life 2021; 14:468-480. [PMID: 34621369 PMCID: PMC8485382 DOI: 10.25122/jml-2020-0119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Accepted: 05/18/2021] [Indexed: 11/17/2022] Open
Abstract
The novel Coronavirus Disease 2019 (COVID-19) has brought unprecedented changes in the way conventional health care is delivered. This study examined if clinicians' perceptions regarding telemedicine and its barriers to implementation in Malaysia have changed during this pandemic. A cross-sectional survey was conducted among Malaysian medical doctors of various specialties in four urban healthcare facilities between June 2020 and July 2020. A total of 146 (41.7%) out of 350 responses were obtained. 62% of doctors reported a reduction greater than 50% in outpatient visits during the COVID-19 pandemic. The majority of doctors either found telemedicine useful in situations similar to COVID-19 (34.2%) or that it is essential to their daily practice (42.5%). However, only 22% reported using telemedicine for consultation during the COVID-19 pandemic. 74% of doctors felt that telemedicine would only benefit up to 30% of their patient population. Significantly more female doctors (80%) felt that telemedicine would benefit their patients compared to male doctors (45.8%) (P=0.03). Physicians (51.3%) were more inclined to adopt telemedicine in comparison to surgeons (32.4%) (P=0.03). The majority cited medico-legal issues and consent (80.6%), billing and charges (66.7%) and insurance reimbursement (62.5%), technical difficulties (62.5%) as their barrier to the adoption of telemedicine. Female doctors and physicians were more willing to adopt telemedicine when compared to male doctors and surgeons. Although the COVID-19 pandemic appeared to improve the perception, significant barriers should be resolved before many can incorporate it into their practice.
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Affiliation(s)
- How Kit Thong
- Department of Otorhinolaryngology, Head and Neck Surgery Faculty of Medicine, KPJ Healthcare University College, Negeri Sembilan, Malaysia
| | - Danny Kit Chung Wong
- Department of Otorhinolaryngology, Head and Neck Surgery Faculty of Medicine, KPJ Healthcare University College, Negeri Sembilan, Malaysia
| | - Hardip Singh Gendeh
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Lokman Saim
- Department of Otorhinolaryngology, Head and Neck Surgery Faculty of Medicine, KPJ Healthcare University College, Negeri Sembilan, Malaysia
- Department of Otorhinolaryngology, Head and Neck Surgery, KPJ Tawakal Specialist Hospital, Kuala Lumpur, Malaysia
| | - Primuharsa Putra Bin Sabir Husin Athar
- Department of Otorhinolaryngology, Head and Neck Surgery Faculty of Medicine, KPJ Healthcare University College, Negeri Sembilan, Malaysia
- Department of Otorhinolaryngology, Head and Neck Surgery, KPJ Seremban Specialist Hospital, Negeri Sembilan, Malaysia
| | - Aminuddin Saim
- Department of Otorhinolaryngology, Head and Neck Surgery Faculty of Medicine, KPJ Healthcare University College, Negeri Sembilan, Malaysia
- Department of Otorhinolaryngology, Head and Neck Surgery, KPJ Ampang Puteri Specialist Hospital, Selangor, Malaysia
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22
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Shanbehzadeh M, Kazemi-Arpanahi H, Kalkhajeh SG, Basati G. Systematic review on telemedicine platforms in lockdown periods: Lessons learned from the COVID-19 pandemic. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2021; 10:211. [PMID: 34395648 PMCID: PMC8318195 DOI: 10.4103/jehp.jehp_1419_20] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 11/21/2020] [Indexed: 05/07/2023]
Abstract
With the onset of the coronavirus disease 2019 (COVID-19) outbreak, the transformation of the care delivery model from conventional in-person (face to face) to largely virtual or remote care has been accelerated to appropriately allocate resources and constrain the spread of the virus. In this regard, telemedicine is a breakthrough technology to battle against the COVID-19 emergency. Therefore, we sought to identify the telemedicine applications in the COVID-19 pandemic (tele-COVID) according to interaction modes, transmission modalities, and disease categories. This systematic review was conducted through searching five databases including PubMed, Scopus, ProQuest, Web of Science, and Science Direct. Inclusion criteria were studies clearly outlining any use of telemedicine interactive mode during the COVID-19 pandemic, written in English language and published in peer-reviewed journals in 2020. Finally, 43 articles met the inclusion out of the 1118 search results. Telemedicine provides a diversity of interaction modes and modalities affordable by patients and physicians including short message service, E-mail and web portals, secure telephone calls or VOIP, video calls, interactive mobile health applications (m-Health), remote patient monitoring, and video conferencing. Transmission of video data using synchronized video calls via common social media had the highest and exchange of data using store-forward service via secure messaging technology and prerecorded multimedia had the lowest popularity for virtual disease management during the COVID-19 outbreak. Selection of telemedicine communication services and interaction modes with regard to its use-case, disease category, and application plays a significant role in the success of remote disease management infrastructures in this scenario and their implication for a better future healthcare system.
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Affiliation(s)
- Mostafa Shanbehzadeh
- Department of Health Information Technology, School of Paramedical, Ilam University of Medical Sciences, Ilam, Iran
| | - Hadi Kazemi-Arpanahi
- Department of Heath Information Technology, Abadan University of Medical Sciences, Abadan, Iran
- Student Research Committee, Abadan University of Medical Sciences, Abadan, Iran
| | | | - Gholam Basati
- Department of Biochemistry, School of Medicine Biotechnology and Medicinal Plants Research Center, Ilam University of Medical Sciences, Ilam, Iran
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23
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Sharma A, Bowman R, Ettema SL, Gregory SR, Javadi P, Johnson MD, Butcher ML, Mutua E, Stack BC, Crosby DL. Rapid telehealth implementation into an otolaryngology practice during the COVID-19 pandemic. Laryngoscope Investig Otolaryngol 2021; 6:386-393. [PMID: 34195358 PMCID: PMC8223471 DOI: 10.1002/lio2.552] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 03/08/2021] [Accepted: 03/17/2021] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE Report outcomes of rapid implementation of telehealth across an academic otolaryngology-head and neck surgery department during the COVID-19 pandemic. METHODS This is a retrospective, single-institution study of rapid deployment of telehealth during the COVID-19 pandemic. Characteristics of patients were compared between those who agreed and those who declined telehealth care. Reasons for declining telehealth visits were ascertained. Characteristics of telehealth visits were collected and patients were asked to complete a post-visit satisfaction survey. RESULTS There was a 68% acceptance rate for telehealth visits. In multivariable analysis, patients were more likely to accept telehealth if they were being seen in the facial plastics subspecialty clinic (odds ratio [OR] 59.55, 95% confidence interval [CI] 2.21-1607.52; P = .015) compared to the general otolaryngology clinic. Patients with Medicare (compared to commercial insurance) as their primary insurance were less likely to accept telehealth visits (OR 0.10, 95% CI 0.01-0.77; P = .027). Two hundred and thirty one patients underwent telehealth visits; most visits (69%) were for established patients and residents were involved in 38% of visits. There was an 85% response rate to the post-visit survey. On a scale of one to ten, the median satisfaction score was 10 and 99% of patients gave a score of 8 or higher. Satisfaction scores were higher for new patient visits than established patient visits (P = .020). CONCLUSION Rapid implementation of telehealth in an academic otolaryngology-head and neck surgery department is feasible. There was high acceptance of and satisfaction scores with telehealth. LEVEL OF EVIDENCE 3.
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Affiliation(s)
- Arun Sharma
- Department of Otolaryngology – Head and Neck SurgerySouthern Illinois University School of MedicineSpringfieldIllinoisUSA
| | - Ryan Bowman
- Department of Otolaryngology – Head and Neck SurgerySouthern Illinois University School of MedicineSpringfieldIllinoisUSA
| | - Sandra L. Ettema
- Department of Otolaryngology – Head and Neck SurgerySouthern Illinois University School of MedicineSpringfieldIllinoisUSA
| | - Stacie R. Gregory
- Department of Otolaryngology – Head and Neck SurgerySouthern Illinois University School of MedicineSpringfieldIllinoisUSA
| | - Pardis Javadi
- Department of Otolaryngology – Head and Neck SurgerySouthern Illinois University School of MedicineSpringfieldIllinoisUSA
| | - Matthew D. Johnson
- Department of Otolaryngology – Head and Neck SurgerySouthern Illinois University School of MedicineSpringfieldIllinoisUSA
| | - Marissa L. Butcher
- Department of Otolaryngology – Head and Neck SurgerySouthern Illinois University School of MedicineSpringfieldIllinoisUSA
| | - Evans Mutua
- Department of Otolaryngology – Head and Neck SurgerySouthern Illinois University School of MedicineSpringfieldIllinoisUSA
| | - Brendan C. Stack
- Department of Otolaryngology – Head and Neck SurgerySouthern Illinois University School of MedicineSpringfieldIllinoisUSA
| | - Dana L. Crosby
- Department of Otolaryngology – Head and Neck SurgerySouthern Illinois University School of MedicineSpringfieldIllinoisUSA
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24
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Gonzalez JN, Axiotakis LG, Yu VX, Gudis DA, Overdevest JB. Practice of Telehealth in Otolaryngology: A Scoping Review in the Era of COVID-19. Otolaryngol Head Neck Surg 2021; 166:417-424. [PMID: 34003046 DOI: 10.1177/01945998211013751] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has spurred widespread adoption and advancement in telehealth activities, representing a marked change in otolaryngology practice patterns. The present study undertakes a scoping review of research focused on telehealth in otolaryngology (teleotolaryngology) to identify key themes and commonly utilized outcome measures that will assist future development in this growing field. DATA SOURCES PubMed, Embase, and Cochrane databases and reference review. REVIEW METHODS Per guidelines of the PRISMA Extension for Scoping Reviews, we performed database queries using a comprehensive search strategy developed in collaboration with research librarians at the Columbia University Irving Medical Center. We identified 596 unique references to undergo title and abstract review by 2 independent reviewers, leaving 439 studies for full-text review. RESULTS We included 285 studies for extraction of notable findings, leaving 262 unique studies after accounting for content overlap. We identified core outcome measures, including patient and provider satisfaction, costs and benefits, quality of care, feasibility, and access to care. Publication volume increased markedly over time, though only 4% of studies incorporated randomized study group assignment. Using an iterative approach to thematic development, we organized article content across 5 main themes: (1) exploration of teleotolaryngology evolution, (2) role in virtual clinical encounters, (3) applications in interdisciplinary care and educational initiatives, (4) emerging and innovative technologies, and (5) barriers to implementation. CONCLUSION This scoping review of teleotolaryngology documents its evolution and identifies current use cases, limitations, and emerging applications, providing a foundation from which to build future studies, inform policy decision making, and facilitate implementation where appropriate.
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Affiliation(s)
- Joseph N Gonzalez
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Lucas G Axiotakis
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Victoria X Yu
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA.,Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, New York, USA
| | - David A Gudis
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA.,Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, New York, USA
| | - Jonathan B Overdevest
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA.,Department of Otolaryngology-Head and Neck Surgery, Columbia University Irving Medical Center, NewYork-Presbyterian Hospital, New York, New York, USA
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Hong W, Lee WG. Wearable sensors for continuous oral cavity and dietary monitoring toward personalized healthcare and digital medicine. Analyst 2021; 145:7796-7808. [PMID: 33107873 DOI: 10.1039/d0an01484b] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Oral monitoring plays an essential role in preventing and diagnosing systemic diseases through saliva in the mouth. Dietary monitoring is also crucial to reduce the likelihood of chronic diseases such as hypertension and diabetes by analyzing food types, amounts and diet patterns. Therefore, the oral cavity and dietary monitoring are vital for accurate personalized healthcare management that can improve healthcare. To perform continuous oral cavity and dietary monitoring in real-time, a wearable sensing system capable of continuous analysis is necessary. In this review, we classify chemical and physical biosensing methods and summarize recent progress in wearable sensor development for oral cavity and dietary monitoring for personalized healthcare and digital medicine. We also discuss future perspectives and the potential of wearable sensors to provide robust data for food-intake monitoring and the saliva analysis of super-aged/aging societies, non-face-to-face social life, and global pandemic disease issues. We believe that this review will result in a paradigm shift toward personalized healthcare and digital medicine using wearable sensors through the analysis of massively parallel healthcare data.
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Affiliation(s)
- Wonki Hong
- Department of Mechanical Engineering, Kyung Hee University, Yongin 17104, Republic of Korea.
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Samarrai R, Riccardi AC, Tessema B, Setzen M, Brown SM. Continuation of telemedicine in otolaryngology post-COVID-19: Applications by subspecialty. Am J Otolaryngol 2021; 42:102928. [PMID: 33545447 PMCID: PMC7816955 DOI: 10.1016/j.amjoto.2021.102928] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 01/12/2021] [Indexed: 12/12/2022]
Abstract
Objective The purpose of this paper is to review the literature and compile key clinically relevant applications of telemedicine for use in otolaryngology relevant to the post-COVID-19 era. Study design Systematic Literature Review. Data sources Pubmed and Google Scholar. Review methods Pubmed and Google Scholar were queried using combined key words such as “telemedicine,” “covid” and “otolaryngology.” The searches were completed in March–August 2020. Additional queries were made with particular subspecialty phrases such as “rhinology” or “otology” to maximize yield of relevant titles. Relevant articles were selected for abstract review. Applicable abstracts were then selected for review of the full text. Results Initial search identified 279 results. These were screened for relevance and 100 abstracts were selected for review. Abstracts were excluded if they were not in English, not related to otolaryngology, or if the full text was unavailable for access. Of these, 37 articles were selected for complete review of the full text. Conclusion The sudden healthcare closures during the COVID-19 pandemic resulted in a sharp increase in the use of telemedicine, particularly in subspecialty fields. Otolaryngologists are at a unique risk of infection resulting from the examination of the head and neck and aerosol-generating procedures due to the predilection of viral particles for the nasal cavities and pharynx. The COVID-19 pandemic may have served as a catalyst to implement telemedicine into clinical practice, however identifying ways to integrate telemedicine long term is key for a sustainable and viable practice in the post-COVID-19 era. Although many states are now finding themselves on the down-sloping side of their infection rate curve, many others remain at the apex. Additionally, the risk of future waves of this pandemic, or the onset of another pandemic, should not be overlooked. Practice modification guidelines that mitigate infection risk by utilizing telemedicine would be useful in these instances. Telemedicine can help to reduce infection spread by limiting unnecessary in-person interactions and help conserve personal protective equipment (PPE) by facilitating remote care with the added benefits of expanding care to broad geographic areas, limiting cost, time, and travel burden on patients and families, and enabling consistent follow up.
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Smith KA, Thamboo A, Chan Y, Chin CJ, Werger M, Rotenberg B. Virtual Care in Rhinology. J Otolaryngol Head Neck Surg 2021; 50:24. [PMID: 33849641 PMCID: PMC8042468 DOI: 10.1186/s40463-021-00505-1] [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] [Received: 10/10/2020] [Accepted: 02/22/2021] [Indexed: 12/02/2022] Open
Abstract
Background The SARS-CoV-2 (COVID) pandemic has resulted in an increase in virtual care. While some specialties are well suited to virtual care, Otolaryngology – Head and Neck Surgery could be limited due to reliance on physical examination and nasal endoscopy, including Rhinology. It is likely virtual care will remain integrated for the foreseeable future and it is important to determine the strengths and weaknesses of this treatment modality for rhinology. Methods A survey on virtual care in rhinology was distributed to 61 Canadian rhinologists. The primary objective was to determine how virtual care compared to in-person care in each area of a typical appointment. Other areas focused on platforms used to deliver virtual care and which patients could be appropriately assessed by virtual visits. Results 43 participants responded (response rate 70.5%). The majority of participants use the telephone as their primary platform. History taking and reviewing results (lab work, imaging) were reported to be equivalent in virtual care. Non-urgent follow up and new patients were thought to be the most appropriate for virtual care. The inability to perform exams and nasal endoscopy were reported to be significant limitations. Conclusion It is important to understand the strengths and limitations of virtual care. These results identify the perceived strengths and weaknesses of virtual care in rhinology, and will help rhinologists understand the role of virtual care in their practices. Graphical abstract ![]()
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Affiliation(s)
- Kristine A Smith
- Department of Otolaryngology - Head and Neck Surgery, University of Manitoba, GB421B - 820 Sherbrook Street, Winnipeg, Manitoba, Canada.
| | - Andrew Thamboo
- Division of Otolaryngology - Head & Neck Surgery, Department of Surgery, University of British Columbia, Vancouver, Canada
| | - Yvonne Chan
- Department of Otolaryngology - Head & Neck Surgery, University of Toronto, Toronto, Canada
| | - Christopher J Chin
- Divsion of Otolaryngology-Head and Neck Surgery, Dalhousie University, Saint John, NB, Canada
| | | | - Brian Rotenberg
- Department of Otolaryngology - Head and Neck Surgery, Schulich School of Medicine and Dentistry, Western University, London, Canada
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Nana-Sinkam P, Kraschnewski J, Sacco R, Chavez J, Fouad M, Gal T, AuYoung M, Namoos A, Winn R, Sheppard V, Corbie-Smith G, Behar-Zusman V. Health disparities and equity in the era of COVID-19. J Clin Transl Sci 2021; 5:e99. [PMID: 34192054 PMCID: PMC8167251 DOI: 10.1017/cts.2021.23] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/28/2021] [Accepted: 03/04/2021] [Indexed: 01/21/2023] Open
Abstract
Over the last year, COVID-19 has emerged as a highly transmissible and lethal infection. As we address this global pandemic, its disproportionate impact on Black, Indigenous, and Latinx communities has served to further magnify the health inequities in access and treatment that persist in our communities. These sobering realities should serve as the impetus for reexamination of the root causes of inequities in our health system. An increased commitment to strategic partnerships between academic and nonacademic health systems, industry, local communities, and policy-makers may serve as the foundation. Here, we examine the impact of the recent COVID-19 pandemic on health care inequities and propose a strategic roadmap for integration of clinical and translational research into our understanding of health inequities.
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Affiliation(s)
| | - Jennifer Kraschnewski
- Division of General Internal Medicine, Penn State College of Medicine, Hershey, PA, USA
| | - Ralph Sacco
- Department of Neurology, University of Miami Health, Miami, FL, USA
| | | | - Mona Fouad
- Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Tamas Gal
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Asmaa Namoos
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Robert Winn
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Vanessa Sheppard
- Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Giselle Corbie-Smith
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, USA
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Fassas S, Cummings E, Sykes KJ, Bur AM, Shnayder Y, Kakarala K. Telemedicine for head and neck cancer surveillance in the COVID-19 era: Promise and pitfalls. Head Neck 2021; 43:1872-1880. [PMID: 33660409 PMCID: PMC8013462 DOI: 10.1002/hed.26659] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 12/14/2020] [Accepted: 02/19/2021] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 pandemic has led to increased telemedicine visits. This study examines current preferences and barriers for telemedicine among patients with head and neck cancer. METHODS Single institution retrospective analysis of 64 patients scheduling visits with the head and neck surgical oncology clinic at a tertiary academic medical center. Data were collected detailing patient preferences and barriers regarding telemedicine appointments. Patients electing to participate in telemedicine were compared to those preferring in-person appointments. RESULTS Most patients (68%) were not interested in telemedicine. Preference for in-person examination was the most common reason for rejecting telemedicine, followed by discomfort with or limited access to technology. Patients elected telemedicine visits to avoid infection and for convenience. CONCLUSIONS When given a choice, patients with head and neck cancer preferred in-person visits over telemedicine. Although telemedicine may improve health care access, patient preferences, technology-related barriers, and limitations regarding cancer surveillance must be addressed moving forward.
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Affiliation(s)
- Scott Fassas
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Emily Cummings
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Kevin J Sykes
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Andrés M Bur
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Yelizaveta Shnayder
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, Kansas, USA
| | - Kiran Kakarala
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City, Kansas, USA
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Al-Sofiani ME, Alyusuf EY, Alharthi S, Alguwaihes AM, Al-Khalifah R, Alfadda A. Rapid Implementation of a Diabetes Telemedicine Clinic During the Coronavirus Disease 2019 Outbreak: Our Protocol, Experience, and Satisfaction Reports in Saudi Arabia. J Diabetes Sci Technol 2021; 15:329-338. [PMID: 32762362 PMCID: PMC7925440 DOI: 10.1177/1932296820947094] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The importance of telemedicine in diabetes care became more evident during the coronavirus disease 2019 (COVID-19) pandemic as many people with diabetes, especially those in areas without well-established telemedicine, lost access to their health care providers (HCPs) during this pandemic. SUBJECTS AND METHODS We describe a simplified protocol of a Diabetes Telemedicine Clinic that utilizes technological tools readily available to most people with diabetes and clinics around the world. We report the satisfaction of 145 patients and 14 HCPs who participated in the virtual clinic and 210 patients who attended the virtual educational sessions about "Diabetes and Ramadan." RESULTS The majority of patients agreed or strongly agreed that the use of telemedicine was essential in maintaining a good glucose control during the pandemic (97%) and they would use the clinic again in the future (86%). A similar high satisfaction was reported by patients who attended the "Diabetes and Ramadan" virtual educational session and 88% of them recommended continuing this activity as a virtual session every year. Majority of the HCPs (93%) thought the clinic protocol was simple and did not require a dedicated orientation session prior to implementing. CONCLUSIONS The simplicity of our Diabetes Telemedicine Clinic protocol and the high satisfaction reported by patients and HCPs make it a suitable model to be adopted by clinics, especially during pandemics or disasters in resource-limited settings. This clinic model can be quickly implemented and does not require technological tools other than those widely available to most people with diabetes, nowadays. We were able to successfully reduce the number of patients, HCPs, and staff physically present in the clinics during the COVID-19 pandemic without negatively impacting the patients' nor the HCPs' satisfaction with the visits.
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Affiliation(s)
- Mohammed E. Al-Sofiani
- Division of Endocrinology, Department of
Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi
Arabia
- Division of Endocrinology, Diabetes and
Metabolism, The Johns Hopkins University, Baltimore, MD, USA
- Strategic Center for Diabetes Research,
College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Mohammed E. Al-Sofiani, MBBS, MSc, Division
of Endocrinology, Diabetes and Metabolism, College of Medicine, King Saud
University, Riyadh 11461, Saudi Arabia.
| | - Ebtihal Y. Alyusuf
- Division of Endocrinology, Department of
Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi
Arabia
| | - Sahar Alharthi
- Department of Internal Medicine, College
of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah M. Alguwaihes
- Division of Endocrinology, Department of
Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi
Arabia
| | - Reem Al-Khalifah
- Division of Endocrinology, Department of
Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Assim Alfadda
- Division of Endocrinology, Department of
Internal Medicine, College of Medicine, King Saud University, Riyadh, Saudi
Arabia
- Strategic Center for Diabetes Research,
College of Medicine, King Saud University, Riyadh, Saudi Arabia
- Obesity Research Center, College of
Medicine, King Saud University, Riyadh, Saudi Arabia
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Baudier P, Kondrateva G, Ammi C, Chang V, Schiavone F. Patients' perceptions of teleconsultation during COVID-19: A cross-national study. TECHNOLOGICAL FORECASTING AND SOCIAL CHANGE 2021; 163:120510. [PMID: 33318716 PMCID: PMC7720768 DOI: 10.1016/j.techfore.2020.120510] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/01/2020] [Accepted: 12/02/2020] [Indexed: 05/08/2023]
Abstract
In recent months, humanity has had to deal with a worldwide pandemic called COVID-19, which has caused the death of hundreds of thousands of people and paralyzed the global economy. Struggling to cure infected patients while continuing to care for patients with other pathologies, health authorities have faced the lack of medical staff and infrastructure. This study aimed to investigate the acceptance of teleconsultation solutions by patients, which help to avoid the spread of the disease during this pandemic period. The model was built using some constructs of the technology acceptance model UTAUT2, Personal traits, Availability, and Perceived Risks. A new scale on Contamination Avoidance was developed by the authors. The questionnaire was disseminated in several countries in Europe and Asia and a total sample of 386 respondents was collected. The results emphasize the huge impact of Performance Expectancy, the negative influence of Perceived Risk, and the positive influence of Contamination Avoidance on the adoption of teleconsultation solutions. The findings highlight the moderating effects of Age, Gender, and Country.
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Affiliation(s)
| | | | - Chantal Ammi
- Institut Mines-Télécom Business School, Evry, France
| | - Victor Chang
- Artificial Intelligence and Information Systems Research Group, School of Computing, Engineering and Digital Technologies, Teesside University, Middlesbrough, United Kingdom
| | - Francesco Schiavone
- Parthenope University of Naples, Italy, Department of Management Studies & Quantitative Methods and Paris School of Business, France
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Chong JC, Tan CHN, Chen DZ. Teleophthalmology and its evolving role in a COVID-19 pandemic: A scoping
review. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2021. [DOI: 10.47102/annals-acadmedsg.2020459] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
ABSTRACT
Introduction: Teleophthalmology may assist the healthcare sector in adapting to limitations imposed on
clinical practice by a viral pandemic. A scoping review is performed in this study to assess the current
applications of teleophthalmology for its suitability to diagnose, monitor or manage ophthalmological
conditions with accuracy.
Methods: A search of PubMed was conducted for teleophthalmology-related articles published from
1 January 2018 to 4 May 2020. Only articles that focused on the use of teleophthalmology in terms of
diagnosis and management, as well as its benefits and detriments, were included. The Mixed Methods
Appraisal Tool (MMAT) was used to assess the quality of the included articles.
Results: A total of 38 articles were assessed at the full-text level. There were 2 qualitative studies and
1 quantitative randomised controlled trial, while the majority were either quantitative descriptive studies
(19, 50.0%) or quantitative non-randomised studies (16, 42.1%). Overall, 8 studies described reducing
manpower requirements, 4 described reducing direct patient–doctor contact, 17 described storage of
medical imaging and clinical data, and 9 described real-time teleconferencing. The MMAT analysis
revealed limitations in appropriate sampling strategy in both quantitative non-randomised studies (9 of
16, 56.3%) and quantitative descriptive studies (9 of 19, 47.4%). Cost-effectiveness of teleophthalmology
was not performed in any included study.
Conclusion: This current review of the various aspects of teleophthalmology describes how it may
potentially assist the healthcare sector to cope with the limitations imposed by a viral pandemic through
technology. Further research is required to evaluate the cost-effectiveness of the various strategies.
Keywords: Artificial intelligence, health informatics, ophthalmology, teleconsultation, telemedicine
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Riley PE, Fischer JL, Nagy RE, Watson NL, McCoul ED, Tolisano AM, Riley CA. Patient and Provider Satisfaction With Telemedicine in Otolaryngology. OTO Open 2021; 5:2473974X20981838. [PMID: 33474522 PMCID: PMC7797587 DOI: 10.1177/2473974x20981838] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/11/2020] [Indexed: 12/11/2022] Open
Abstract
Objective The objective of this study is to evaluate patient and provider satisfaction with telemedicine encounters across 3 otolaryngology practices. Study Design Cross-sectional survey. Setting A military community hospital, an academic military hospital, and a nonmilitary academic center. Methods A telephone-based survey of patients undergoing telemedicine encounters for routine otolaryngology appointments was performed between April and July 2020. Patients were asked about their satisfaction, the factors affecting care, and demographic information. A provider survey was emailed to staff otolaryngologists. The survey asked about satisfaction, concerns for reimbursement or liability, encounters best suited for telemedicine, and demographic information. The results were analyzed with descriptive statistics and a multivariable logistic linear regression model to determine odds ratios. Results A total of 325 patients were surveyed, demonstrating high satisfaction with telemedicine (average score, 4.49 of 5 [best possible answer]). Patients perceived “no negative impact” or “minor negative impact” on the encounter due to the lack of a physical examination or face-to-face interaction (1.86 and 1.95 of 5, respectively). High satisfaction was consistent across groups for distance to travel, age, and reason for referral. A total of 25 providers were surveyed, with an average satisfaction score of 3.44 of 5. Providers reported “slight” to “somewhat” concern about reimbursement (40%) and liability (32%). Conclusion Given patients’ and providers’ levels of satisfaction, there is likely a role for telemedicine in otolaryngology practice that may benefit patient care independent of the COVID-19 pandemic.
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Affiliation(s)
- Phoebe Elizabeth Riley
- Department of Otolaryngology-Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Jakob L Fischer
- Department of Otolaryngology-Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Ryan E Nagy
- School of Medicine, Tulane University, New Orleans, Louisiana, USA
| | - Nora L Watson
- Department of Research Programs, Walter Reed National Military Medical Center, Bethesda, Maryland, USA
| | - Edward D McCoul
- Department of Otolaryngology-Head and Neck Surgery, Ochsner Medical Center, New Orleans, Louisiana, USA
| | - Anthony M Tolisano
- Department of Otolaryngology-Head and Neck Surgery, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.,Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Charles A Riley
- Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA.,Department of Otolaryngology-Head and Neck Surgery, Fort Belvoir Community Hospital, Fort Belvoir, Virginia, USA
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The impact of the COVID-19 outbreak on supportive care for oral mucositis: current concepts and practice. Support Care Cancer 2021; 29:2255-2258. [PMID: 33392774 PMCID: PMC7779243 DOI: 10.1007/s00520-020-05966-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/16/2020] [Indexed: 01/12/2023]
Abstract
The outbreak of coronavirus disease 2019 (COVID-19) markedly affected the way healthcare professionals approach patients with cancer worldwide, not only in terms of therapeutic decision-making but also in terms of supportive care. With the rapid appearance of signs and symptoms and the need of close re-assessment, standard management of oral mucositis has been challenged by physical distancing and limited resources due to the global crisis. Building on the clinical experience developed during the acute phase by members of the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO), the implications of COVID-19 on the prevention, assessment, and treatment of mucositis are critically reported. Inspired by the restructuring of supportive care measures in response to the pandemic, suggestions for new models of approaching acute side effects are also discussed.
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Erben Y, Franco-Mesa C, Hamid O, Lin M, Stone W, Meltzer AJ, Hattery W, Palaj A, Wilshusen LL, Vista TL, Kalra M, Farres H, Bower TC, De Martino RR, Huang JF, Meschia JF, TerKonda SP. Telemedicine in vascular surgery during the coronavirus disease-2019 pandemic: A multisite healthcare system experience. J Vasc Surg 2020; 74:1-4. [PMID: 33338578 PMCID: PMC7738278 DOI: 10.1016/j.jvs.2020.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 12/06/2020] [Indexed: 01/15/2023]
Abstract
Objective To assess the introduction of telemedicine as an alternative to the traditional face-to-face encounters with vascular surgery patients in the era of the coronavirus disease 2019 (COVID-19) pandemic. Methods A retrospective review of prospectively collected data on face-to-face and telemedicine interactions was conducted at a multisite health care system from January to August 2020 in vascular surgery patients during the COVID-19 pandemic. The end point is direct patient satisfaction comparison between face-to-face and telemedicine encounters/interactions prior and during the pandemic. Results There were 6262 patient encounters from January 1, 2020, to August 6, 2020. Of the total encounters, 790 (12.6%) were via telemedicine, which were initiated on March 11, 2020, after the World Health Organization's declaration of the COVID-19 pandemic. These telemedicine encounters were readily adopted and embraced by both the providers and patients and remain popular as an option to patients for all types of visits. Of these patients, 78.7% rated their overall health care experience during face-to-face encounters as very good and 80.6% of patients rated their health care experience during telemedicine encounters as very good (P = .78). Conclusions Although the COVID-19 pandemic has produced unprecedented consequences to the practice of medicine and specifically of vascular surgery, our multisite health care system has been able to swiftly adapt and adopt telemedicine technologies for the care of our complex patients. Most important, the high quality of patient-reported satisfaction and health care experience has remained unchanged.
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Affiliation(s)
- Young Erben
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, Fla.
| | - Camila Franco-Mesa
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, Fla
| | - Osman Hamid
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, Fla
| | - Michelle Lin
- Department of Neurology, Mayo Clinic, Jacksonville, Fla
| | - William Stone
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Scottsdale, Ariz
| | - Andrew J Meltzer
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Scottsdale, Ariz
| | - Wendy Hattery
- Center for Connected Care, Mayo Clinic, Jacksonville, Fla
| | - Arta Palaj
- Office of Access Management, Mayo Clinic, Jacksonville, Fla
| | | | - Tafi L Vista
- Patient Experience Research, Mayo Clinic, Jacksonville, Fla
| | - Manju Kalra
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn
| | - Houssam Farres
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, Fla
| | - Thomas C Bower
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minn
| | | | | | | | - Sarvam P TerKonda
- Center for Connected Care, Mayo Clinic, Jacksonville, Fla; Division of Plastic and Reconstructive Surgery, Mayo Clinic, Jacksonville, Fla
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Naunheim MR, Zhou AS, Puka E, Franco RA, Carroll TL, Teng SE, Mallur PS, Song PC. Laryngeal complications of COVID-19. Laryngoscope Investig Otolaryngol 2020; 5:1117-1124. [PMID: 33364402 PMCID: PMC7752067 DOI: 10.1002/lio2.484] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/06/2020] [Accepted: 10/10/2020] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To describe and visually depict laryngeal complications in patients recovering from coronavirus disease 2019 (COVID-19) infection along with associated patient characteristics. STUDY DESIGN Prospective patient series. SETTING Tertiary laryngology care centers. SUBJECTS AND METHODS Twenty consecutive patients aged 18 years or older presenting with laryngological complaints following recent COVID-19 infection were included. Patient demographics, comorbid medical conditions, COVID-19 diagnosis dates, symptoms, intubation, and tracheostomy status, along with subsequent laryngological symptoms related to voice, airway, and swallowing were collected. Findings on laryngoscopy and stroboscopy were included, if performed. RESULTS Of the 20 patients enrolled, 65% had been intubated for an average duration of 21.8 days and 69.2% requiring prone-position mechanical ventilation. Voice-related complaints were the most common presenting symptom, followed by those related to swallowing and breathing. All patients who underwent flexible laryngoscopy demonstrated laryngeal abnormalities, most frequently in the glottis (93.8%), and those who underwent stroboscopy had abnormalities in mucosal wave (87.5%), periodicity (75%), closure (50%), and symmetry (50%). Unilateral vocal fold immobility was the most common diagnosis (40%), along with posterior glottic (15%) and subglottic (10%) stenoses. 45% of patients underwent further procedural intervention in the operating room or office. Many findings were suggestive of intubation-related injury. CONCLUSION Prolonged intubation with prone-positioning commonly employed in COVID-19 respiratory failure can lead to significant laryngeal complications with associated difficulties in voice, airway, and swallowing. The high percentage of glottic injuries underscores the importance of stroboscopic examination. Otolaryngologists must be prepared to manage these complications in patients recovering from COVID-19. LEVEL OF EVIDENCE IV.
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Affiliation(s)
- Matthew R. Naunheim
- Department of Otolaryngology—Head and Neck SurgeryMassachusetts Eye and Ear InfirmaryBostonMassachusettsUSA
- Department of Otolaryngology—Head and Neck SurgeryHarvard Medical SchoolBostonMassachusettsUSA
| | - Allen S. Zhou
- Department of Otolaryngology—Head and Neck SurgeryMassachusetts Eye and Ear InfirmaryBostonMassachusettsUSA
- Department of Otolaryngology—Head and Neck SurgeryHarvard Medical SchoolBostonMassachusettsUSA
| | - Elefteria Puka
- Department of Otolaryngology—Head and Neck SurgeryMassachusetts Eye and Ear InfirmaryBostonMassachusettsUSA
- Department of Otolaryngology—Head and Neck SurgeryHarvard Medical SchoolBostonMassachusettsUSA
| | - Ramon A. Franco
- Department of Otolaryngology—Head and Neck SurgeryMassachusetts Eye and Ear InfirmaryBostonMassachusettsUSA
- Department of Otolaryngology—Head and Neck SurgeryHarvard Medical SchoolBostonMassachusettsUSA
| | - Thomas L. Carroll
- Department of Otolaryngology—Head and Neck SurgeryHarvard Medical SchoolBostonMassachusettsUSA
- Division of OtolaryngologyBrigham and Womens HospitalBostonMAUSA
| | - Stephanie E. Teng
- Department of Otolaryngology—Head and Neck SurgeryHarvard Medical SchoolBostonMassachusettsUSA
- Division of OtolaryngologyBeth Israel Deaconess Medical CenterBostonMAUSA
| | - Pavan S. Mallur
- Department of Otolaryngology—Head and Neck SurgeryHarvard Medical SchoolBostonMassachusettsUSA
- Division of OtolaryngologyBeth Israel Deaconess Medical CenterBostonMAUSA
| | - Phillip C. Song
- Department of Otolaryngology—Head and Neck SurgeryMassachusetts Eye and Ear InfirmaryBostonMassachusettsUSA
- Department of Otolaryngology—Head and Neck SurgeryHarvard Medical SchoolBostonMassachusettsUSA
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Itamura K, Tang DM, Higgins TS, Rimell FL, Illing EA, Ting JY, Lee MK, Wu A. Comparison of Patient Satisfaction Between Virtual Visits During the COVID-19 Pandemic and In-person Visits Pre-pandemic. Ann Otol Rhinol Laryngol 2020; 130:810-817. [PMID: 33251849 PMCID: PMC8174012 DOI: 10.1177/0003489420977766] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To compare the patient experience of a virtual otolaryngology clinic visit to an in-person visit, especially with its significantly increased implementation during the COVID-19 pandemic. Methods: Patient satisfaction (PS) metrics from the Clinician and Group Consumer Assessment of Healthcare Providers and Systems survey were queried from March 1, 2020 to May 1, 2020 for telehealth visits and January 1, 2020 to March 1, 2020 for in-person visits. Overlapping and comparable questions were analyzed using Mann-Whitney U test, Chi-square test for independence, and Student’s t-test. Results: There were 1284 partial or complete PS surveys from in-person visits and 221 partial or complete virtual PS surveys. There were statistically significantly worse virtual visit evaluations of provider listening, conveyance of information, likelihood to recommend, and overall provider ratings compared to in-person visits. Conclusion: Telehealth has become the new norm for most healthcare providers in the United States. This study demonstrates some of the initial shortcomings of telehealth in an otolaryngology practice and identifies challenges with interpersonal communication that may need to be addressed as telehealth becomes increasingly prevalent. Level of Evidence: 3.
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Affiliation(s)
- Kyohei Itamura
- Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Dennis M Tang
- Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Thomas S Higgins
- Department of Otolaryngology-Head and Neck Surgery, Louisville University, Louisville, KY, USA
| | - Franklin L Rimell
- Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Elisa A Illing
- Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, IN, USA
| | - Jonathan Y Ting
- Department of Otolaryngology-Head and Neck Surgery, Indiana University, Indianapolis, IN, USA
| | - Matthew K Lee
- Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Arthur Wu
- Division of Otolaryngology-Head and Neck Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Belcher RH, Phillips J, Virgin F, Werkhaven J, Whigham A, Wilcox L, Wootten CT. Pediatric Otolaryngology Telehealth in Response to COVID-19 Pandemic: Lessons Learned and Impact on the Future Management of Pediatric Patients. Ann Otol Rhinol Laryngol 2020; 130:788-795. [PMID: 33238714 PMCID: PMC7691763 DOI: 10.1177/0003489420976163] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Since the start of the COVID-19 pandemic outpatient medicine has drastically been altered how it is delivered. This time period likely represents the largest volume of telehealth visits in the United States health care history. Telehealth presents unique challenges within each subspecialty, and pediatric otolaryngology is no different. This retrospective review was designed to evaluate our division of pediatric otolaryngology’s experience with telehealth during the COVID19 pandemic. Methods: This study was approved by the Institutional Review Board at Vanderbilt University Medical Center. All telehealth and face-to-face visits for the month of April 2020 completed by the Pediatric Otolaryngology Division were reviewed. A survey, utilizing both open-ended questions and Likert scaled questions was distributed to the 16 pediatric otolaryngology providers in our group to reflect their experience with telehealth during the 1-month study period. Results: In April, 2020 our outpatient clinic performed a total of 877 clinic visits compared to 2260 clinic visits in April 2019. A total of 769 (88%) were telehealth visits. Telemedicine with video comprised 523 (68%) and telephone only comprised 246 (32%). There were 0 telehealth visits in April 2019. Interpretive services were required in 9.3% (N = 211) clinic visits in April 2019 and 7.5% (N = 66) of clinic visits in April 2020. The survey demonstrated a significant difference (P < .00002) in provider’s anticipated telehealth experience (mean 3.94, 95% CI [3.0632, 4.8118] compared to their actual experience after the study period (mean 7.5, 95% CI [7.113, 7.887]. Conclusions: Despite low initial expectations for telehealth, the majority of our providers felt after 1 month of use that telehealth would continue to be a valuable platform post-pandemic clinical practice. Limited physical exam, particularly otoscopy, nasal endoscopy, and nasolaryngoscopy present challenges. However, with adequate information and preparation for the parents and for the physician some of the obstacles can be overcome.
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Affiliation(s)
- Ryan H Belcher
- Pediatric Otolaryngology - Head and Neck Surgery at Vanderbilt Children's Hospital, Nashville, TN, USA
| | - James Phillips
- Pediatric Otolaryngology - Head and Neck Surgery at Vanderbilt Children's Hospital, Nashville, TN, USA
| | - Frank Virgin
- Pediatric Otolaryngology - Head and Neck Surgery at Vanderbilt Children's Hospital, Nashville, TN, USA
| | - Jay Werkhaven
- Pediatric Otolaryngology - Head and Neck Surgery at Vanderbilt Children's Hospital, Nashville, TN, USA
| | - Amy Whigham
- Pediatric Otolaryngology - Head and Neck Surgery at Vanderbilt Children's Hospital, Nashville, TN, USA
| | - Lyndy Wilcox
- Pediatric Otolaryngology - Head and Neck Surgery at Vanderbilt Children's Hospital, Nashville, TN, USA
| | - Christopher T Wootten
- Pediatric Otolaryngology - Head and Neck Surgery at Vanderbilt Children's Hospital, Nashville, TN, USA
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Golinelli D, Boetto E, Carullo G, Nuzzolese AG, Landini MP, Fantini MP. Adoption of Digital Technologies in Health Care During the COVID-19 Pandemic: Systematic Review of Early Scientific Literature. J Med Internet Res 2020; 22:e22280. [PMID: 33079693 PMCID: PMC7652596 DOI: 10.2196/22280] [Citation(s) in RCA: 193] [Impact Index Per Article: 48.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 07/25/2020] [Accepted: 09/15/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic is favoring digital transitions in many industries and in society as a whole. Health care organizations have responded to the first phase of the pandemic by rapidly adopting digital solutions and advanced technology tools. OBJECTIVE The aim of this review is to describe the digital solutions that have been reported in the early scientific literature to mitigate the impact of COVID-19 on individuals and health systems. METHODS We conducted a systematic review of early COVID-19-related literature (from January 1 to April 30, 2020) by searching MEDLINE and medRxiv with appropriate terms to find relevant literature on the use of digital technologies in response to the pandemic. We extracted study characteristics such as the paper title, journal, and publication date, and we categorized the retrieved papers by the type of technology and patient needs addressed. We built a scoring rubric by cross-classifying the patient needs with the type of technology. We also extracted information and classified each technology reported by the selected articles according to health care system target, grade of innovation, and scalability to other geographical areas. RESULTS The search identified 269 articles, of which 124 full-text articles were assessed and included in the review after screening. Most of the selected articles addressed the use of digital technologies for diagnosis, surveillance, and prevention. We report that most of these digital solutions and innovative technologies have been proposed for the diagnosis of COVID-19. In particular, within the reviewed articles, we identified numerous suggestions on the use of artificial intelligence (AI)-powered tools for the diagnosis and screening of COVID-19. Digital technologies are also useful for prevention and surveillance measures, such as contact-tracing apps and monitoring of internet searches and social media usage. Fewer scientific contributions address the use of digital technologies for lifestyle empowerment or patient engagement. CONCLUSIONS In the field of diagnosis, digital solutions that integrate with traditional methods, such as AI-based diagnostic algorithms based both on imaging and clinical data, appear to be promising. For surveillance, digital apps have already proven their effectiveness; however, problems related to privacy and usability remain. For other patient needs, several solutions have been proposed, such as telemedicine or telehealth tools. These tools have long been available, but this historical moment may actually be favoring their definitive large-scale adoption. It is worth taking advantage of the impetus provided by the crisis; it is also important to keep track of the digital solutions currently being proposed to implement best practices and models of care in future and to adopt at least some of the solutions proposed in the scientific literature, especially in national health systems, which have proved to be particularly resistant to the digital transition in recent years.
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Affiliation(s)
- Davide Golinelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Erik Boetto
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Gherardo Carullo
- Department of Italian and Supranational Public Law, University of Milan, Milan, Italy
| | | | | | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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Incorporation of telemedicine by rhinologists: The COVID-19 pandemic and beyond. Am J Otolaryngol 2020; 41:102567. [PMID: 32920475 PMCID: PMC7264942 DOI: 10.1016/j.amjoto.2020.102567] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 12/15/2022]
Abstract
Objectives The current analysis queries rhinologists' attitudes about the use of telemedicine, including the degree to which it has impacted practice patterns during the COVID-19 pandemic. Our objective was to survey rhinologists and understand the extent to which telemedicine serves as a rejoinder to in-person consultation: appreciation of relevant factors may be important in planning for present and future considerations. Methods A 14-question anonymous survey sent out to the American Rhinologic Society (ARS) membership in April 2020. It included demographic factors and detailed questions examining the extent of telemedicine use. Numerous topics including the degree of use, satisfaction with services, and utility of services were evaluated. Results There were 134 respondents. Most reported seeing ≤30% of typical in-person volume, with 14.8% not seeing any patients at all. 88.1% used telemedicine; 82.0% reported some level of satisfaction with telemedicine. The vast majority utilized platforms employing audio and video (83.3%), and a plurality reported spending 5–15 min on calls. Numerous reasons were cited for the use of telemedicine, including significant public health benefits amid the crisis (89.7%). Only 12.0% of respondents reported using telemedicine for hospital consultation. Conclusion Rhinologists have embraced telemedicine during the COVID-19 pandemic in an attempt to improve accessibility, patient satisfaction, and revenue stream. When utilized appropriately, this technology obviates the need for seeing at-risk patients and performing procedures such as nasal endoscopy. Only a minority of rhinologists was dissatisfied, viewing this as a temporary fix during the pandemic.
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Benito DA, Pasick LJ, Mulcahy CF, Rajasekaran K, Todd-Hesham H, Joshi AS, Goodman JF, Thakkar P. Local spikes in COVID-19 cases: Recommendations for maintaining otolaryngology clinic operations. Am J Otolaryngol 2020; 41:102688. [PMID: 32854044 PMCID: PMC7439996 DOI: 10.1016/j.amjoto.2020.102688] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 08/15/2020] [Indexed: 01/12/2023]
Abstract
The Coronavirus Disease-2019 (COVID-19) pandemic has created an unprecedented economic and public health crisis in the United States. Following efforts to mitigate disease spread, with a significant decline in some regions, many states began reopening their economies. As social distancing guidelines were relaxed and businesses opened, local outbreaks of COVID-19 continue to place person on healthcare systems. Among medical specialties, otolaryngologists and their staff are among the highest at risk for becoming exposed to COVID-19. As otolaryngologists prepare to weather the storm of impending local surges in COVID-19 infections there are several practical measures that can be taken to mitigate the risk to ourselves and our staff.
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Affiliation(s)
- Daniel A Benito
- Division of Otolaryngology - Head & Neck Surgery, George Washington University School of Medicine, United States of America.
| | - Luke J Pasick
- Department of Otolaryngology - Head & Neck Surgery, University of Miami Miller School of Medicine, United States of America
| | - Collin F Mulcahy
- Division of Otolaryngology - Head & Neck Surgery, George Washington University School of Medicine, United States of America
| | - Karthik Rajasekaran
- Department of Otolaryngology - Head & Neck Surgery, University of Pennsylvania Perelman School of Medicine, United States of America
| | - Hosai Todd-Hesham
- Division of Otolaryngology - Head & Neck Surgery, George Washington University School of Medicine, United States of America
| | - Arjun S Joshi
- Division of Otolaryngology - Head & Neck Surgery, George Washington University School of Medicine, United States of America
| | - Joseph F Goodman
- Division of Otolaryngology - Head & Neck Surgery, George Washington University School of Medicine, United States of America
| | - Punam Thakkar
- Division of Otolaryngology - Head & Neck Surgery, George Washington University School of Medicine, United States of America
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Setzen M, Svider PF, Setzen S, Setzen G, Eloy JA, Johnson AP. The novel corona virus and rhinology: Impact on practice patterns and future directions. Am J Otolaryngol 2020; 41:102569. [PMID: 32683188 PMCID: PMC7263239 DOI: 10.1016/j.amjoto.2020.102569] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 05/27/2020] [Indexed: 02/02/2023]
Abstract
Objectives To evaluate the impact of the novel coronavirus pandemic on practice patterns, clinical behavior, personal health, and emotional/psychological concerns of rhinologists. Methods A 15-question survey was sent out to the American Rhinologic Society's (ARS) membership to determine the impact of COVID-19 during the crisis. Demographic factors and practice patterns were collected and evaluated. Results There were 224 total respondents out of 835 ARS members queried (26.8% response rate). Study queries were sent in April 2020. Notably, 17.8% reported illness in themselves or their staff and 74.4% noted a psychological/emotional impact. A plurality of rhinologists noted their practice volume and in-office procedure volume has become 20.0% and 0.0% of their prior volumes, respectively. In addition, 96.2% were noted to be using telemedicine in our subspecialty. Conclusion In addition to severely impacting volume and the perception of future decreases in patients and revenue, the COVID-19 pandemic has had a physical and emotional impact on rhinologists in ways that need to be further studied. These data include significantly novel and objective information. The COVID-19 crisis also reveals the important role of telemedicine in rhinology. Guidelines regarding personal protective equipment for in-office visits, nasal endoscopy, and other in-office and operating room procedures would be particularly helpful as future waves are expected.
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MacDonald L, Cox A, Jarvi K, Martin P, French C, Wang Y, Braga LH, Leveridge M. Navigating urology's new normal and mitigating the effects of a second wave of COVID-19. Can Urol Assoc J 2020; 14:E543-E548. [PMID: 33007189 PMCID: PMC7673836 DOI: 10.5489/cuaj.6976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The initial wave of the COVID-19 crisis forced immediate and seismic changes on urological practice, patient care, and education — collateral damage to the upending of societal and global economic norms. Lockdowns and limitations curtailed access to the physical spaces of the clinic and operating room, and slashed remuneration secondarily. As the curves flattened and healthcare infrastructure was deemed secure, we have begun opening our societies and clinical lives again. Remote care, in particular, has remained the default model of care, with attendant changes in how urological experience and education are obtained. As the colder weather looms, so does uncertainty about repeated waves of infection, the sustainability of the businesses that sustain our economy and the ability to provide high-quality, uninterrupted care outside of emergencies. To this end, we have compiled perspective and advice from previous authors and contributors to the CUA and CUAJ’s educational and research output, with a view to the future, to second waves, and ever-altered clinical landscapes.
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Affiliation(s)
- Landan MacDonald
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Ashley Cox
- Department of Urology, Dalhousie University, Halifax, NS, Canada
| | - Keith Jarvi
- Division of Urology, Department of Surgery, University of Toronto, Toronto, ON, Canada
| | | | - Christopher French
- Department of Surgery, Division of Urology, Memorial University, St. John’s, NL, Canada
| | - Yuding Wang
- Department of Surgery, Division of Urology, McMaster University, Hamilton, ON, Canada
| | - Luis H. Braga
- Department of Surgery, Division of Urology, McMaster University, Hamilton, ON, Canada
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Pier MM, Pasick LJ, Benito DA, Alnouri G, Sataloff RT. Otolaryngology-related Google Search trends during the COVID-19 pandemic. Am J Otolaryngol 2020; 41:102615. [PMID: 32659612 PMCID: PMC7303046 DOI: 10.1016/j.amjoto.2020.102615] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 06/16/2020] [Indexed: 12/18/2022]
Abstract
Objective To assess trends of Google Search queries for symptoms and complaints encountered commonly in otolaryngology practices during the coronavirus disease 2019 (COVID-19) pandemic when in-person care has been limited. Materials and methods In this cross-sectional study, data on Google Search queries in the United States for 30 otolaryngology-related terms were obtained from Google Trends. The means of relative search volume from the COVID-19 period (March 29, 2020 through May 16, 2020) were compared to similar periods from 2016 to 2019 using a t-test of two independent samples. Results In total, 16.6% of search terms had significant increases in relative search volume during the COVID-19 period, with the largest percentage increase for “can't smell” (124.4%, p = .006), followed by “allergies” (30.3%, p = .03), “voice pain” (26.1%, p = .008), and “ears ringing” (19.0%, p < .001). Of all search terms, 26.7% had significant decreases in relative search volume, including the largest percentage decrease for “laryngitis” (59.8%, p < .001), followed by “thyroid nodule” (54.4%, p < .001), “thyroid cancer” (45.6%, p < .001), and “ENT” (34.9%, p < .001). Conclusion This study demonstrates that Google search activity for many otolaryngology-related terms during the COVID-19 pandemic has increased or decreased significantly as compared to previous years. With reduced access to in-office otolaryngology care in the United States during the COVID-19 pandemic, these are important considerations for otolaryngology practices to meet the needs of patients who lack access to care. Otolaryngology-related Google Search activity changed during the COVID-19 pandemic Google Trends provides important insights into patients’ needs during a pandemic Internet search data can guide telehealth implementation in otolaryngology practices
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Affiliation(s)
- Matthew M Pier
- Drexel University College of Medicine, 2900 W Queen Ln, Philadelphia, PA 19129, United States of America.
| | - Luke J Pasick
- Department of Otolaryngology-Head and Neck Surgery, University of Miami Miller School of Medicine, 1120 NW 14th St 5th Floor, Miami, FL 33136, United States of America.
| | - Daniel A Benito
- Division of Otolaryngology-Head and Neck Surgery, George Washington University School of Medicine and Health Sciences. 2150 Pennsylvania Avenue, NW 6B, Washington, DC 20037, United States of America.
| | - Ghiath Alnouri
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, and Lankenau Institute for Medical Research, 219 N. Broad St, 10th Floor, Philadelphia, PA 19107, United States of America.
| | - Robert T Sataloff
- Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, and Lankenau Institute for Medical Research, 219 N. Broad St, 10th Floor, Philadelphia, PA 19107, United States of America.
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Bahl S, Singh RP, Javaid M, Khan IH, Vaishya R, Suman R. Telemedicine Technologies for Confronting COVID-19 Pandemic: A Review. JOURNAL OF INDUSTRIAL INTEGRATION AND MANAGEMENT-INNOVATION AND ENTREPRENEURSHIP 2020. [DOI: 10.1142/s2424862220300057] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Telemedicine (TM) is used to treat patients in a remote location by using telecommunication technology. It exchanges the medical information and data from one location to another through advanced technological innovation. During this COVID-19 pandemic, there is a lockdown in almost all countries. TM is beneficial to healthcare to minimize social distance. This review paper briefs about TM and discusses how this technology works for the COVID-19 pandemic and its significant benefits. An extensive search is made on the known research engines of PubMed, SCOPUS, Google Scholar, and ResearchGate using the appropriate keywords to extract meaningful and relevant articles. Ten major applications of TM for COVID-19 are identified and discussed with a brief description of each provided. The major technological processes involved in TM, which create advancement in the medical field, are also discussed. This technology helps avoid visits to the doctor and hospital during the lockdown and provides a suitable treatment option. It collects the medical information and data, which can be helpful for better treatment of the patient. Telemedicine adopts virtualized treatment approaches for the patient. Now patients can receive better quality treatment without leaving their homes during COVID-19 lockdown.
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Affiliation(s)
- Shashi Bahl
- Department of Mechanical Engineering, I.K. Gujral Punjab Technical University Hoshiarpur Campus, Hoshiarpur 146001, Punjab, India
| | - Ravi Pratap Singh
- Department of Industrial and Production Engineering, Dr. B. R. Ambedkar National Institute of Technology Jalandhar, Jalandhar 144011, Punjab, India
| | - Mohd Javaid
- Department of Mechanical Engineering, Jamia Millia Islamia Jamia Nagar, New Delhi 110025, India
| | - Ibrahim Haleem Khan
- School of Engineering Sciences & Technology, Jamia Hamdard, Hamdard Nagar, New Delhi, India
| | - Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospital, Delhi Mathura Road, New Delhi 110076, India
| | - Rajiv Suman
- Department of Industrial & Production Engineering, Govind Ballabh Pant University of Agriculture & Technology, Udham Singh Nagar, Pantnagar 263153, Uttarakhand, India
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Kim E, Ko K. Misalignment between coronavirus financial aid and public health policies: negative incentives for outpatient clinics in the United States. J Public Health Policy 2020; 42:160-166. [PMID: 32978513 PMCID: PMC7517730 DOI: 10.1057/s41271-020-00256-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2020] [Indexed: 11/21/2022]
Abstract
The United States Coronavirus Aid, Relief, and Economic Security Act (CARES Act) led to creation of the Paycheck Protection Program, as well as an expansion of reimbursements for telemedicine. CARES Act drafters over emphasized maintaining employment and overlooked negative downstream effects the policies had on outpatient clinics. The misalignment between this financial aid package and public health policy is most apparent in the pressure administrators face to maintain clinic operations, without a transition plan to adopt telemedicine and associated best practices. If this continues, the result will be suboptimal clinical practices and an increased risk of COVID-19 infection to both staff and patients. Particularly in times of crisis, financial aid packages should not be evaluated in isolation; policymakers should consider their implications for public health while designing, enacting, and implementing such measures.
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Affiliation(s)
- Edward Kim
- Medical School for International Health, Faculty of Health Sciences, Ben Gurion University of the Negev, Be'er Sheva, Israel.
| | - Kristin Ko
- Department of Physiology and Biophysics, Georgetown University, Washington, DC, USA
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Robiony M, Bocin E, Sembronio S, Costa F, Bresadola V, Tel A. Redesigning the Paradigms of Clinical Practice for Oral and Maxillofacial Surgery in the Era of Lockdown for COVID-19: From Tradition to Telesemeiology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6622. [PMID: 32932911 PMCID: PMC7557395 DOI: 10.3390/ijerph17186622] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 01/31/2023]
Abstract
The rise of the COVID-19 pandemic has posed new challenges for health care institutions. Restrictions imposed by local governments worldwide have compromised the mobility of patients and decreased the number of physicians in hospitals. Additional requirements in terms of medical staff security further limited the physical contact of doctors with their patients, thereby questioning the traditional methods of clinical examination. Our institution has developed an organization model to translate the essential clinical services into virtual consultation rooms using a telemedicine interface which is commonly available to patients. We provide examples of clinical activity for a maxillofacial surgery department based on teleconsultation. Our experience is summarized and an organization model is drafted in which outpatient consultation offices are translated into virtual room environments. Clinical examples are provided, demonstrating how each subspecialty of oral and maxillofacial surgery can benefit from virtual examinations. The concept of "telesemeiology" is introduced and a checklist is presented to guide clinicians to perform teleconsultations. This paper is intended to provide an organization model based on telemedicine for maxillofacial surgeons and aims to represent an aid for colleagues who are facing the pandemic in areas where lockdown limits the possibility of a physical examination.
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Affiliation(s)
- Massimo Robiony
- Department of Medicine, University of Udine, 33100 Udine, Italy; (E.B.); (S.S.); (F.C.); (V.B.); (A.T.)
- Maxillofacial Surgery Department, Academic Hospital of Udine, 33100 Udine, Italy
| | - Elena Bocin
- Department of Medicine, University of Udine, 33100 Udine, Italy; (E.B.); (S.S.); (F.C.); (V.B.); (A.T.)
- Rehabilitation Unit, Academic Hospital of Udine, 33100 Udine, Italy
| | - Salvatore Sembronio
- Department of Medicine, University of Udine, 33100 Udine, Italy; (E.B.); (S.S.); (F.C.); (V.B.); (A.T.)
- Maxillofacial Surgery Department, Academic Hospital of Udine, 33100 Udine, Italy
| | - Fabio Costa
- Department of Medicine, University of Udine, 33100 Udine, Italy; (E.B.); (S.S.); (F.C.); (V.B.); (A.T.)
- Maxillofacial Surgery Department, Academic Hospital of Udine, 33100 Udine, Italy
| | - Vittorio Bresadola
- Department of Medicine, University of Udine, 33100 Udine, Italy; (E.B.); (S.S.); (F.C.); (V.B.); (A.T.)
- Department and Simulation Center, Academic Hospital of Udine, 33100 Udine, Italy
| | - Alessandro Tel
- Department of Medicine, University of Udine, 33100 Udine, Italy; (E.B.); (S.S.); (F.C.); (V.B.); (A.T.)
- Maxillofacial Surgery Department, Academic Hospital of Udine, 33100 Udine, Italy
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Fieux M, Duret S, Bawazeer N, Denoix L, Zaouche S, Tringali S. Téléconsultation en ORL : enquête de satisfaction en période pandémique COVID-19. ANNALES FRANÇAISES D'OTO-RHINO-LARYNGOLOGIE ET DE PATHOLOGIE CERVICO-FACIALE 2020. [PMCID: PMC7298459 DOI: 10.1016/j.aforl.2020.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
But Étudier l’intérêt de la téléconsultation en période de pandémie liée au COVID-19. Matériel et méthodes Étude prospective comportant une enquête de satisfaction réalisée au sein d’un service d’ORL d’un centre hospitalo-universitaire où la téléconsultation a été mise en place pour remplacer les consultations programmées. Les patients étaient répartis en deux groupes selon leur niveau de satisfaction pour en identifier les facteurs prédictifs. Une valeur de p < 0,005 était considérée statistiquement significative. L’objectif principal était d’évaluer le taux de satisfaction des patients à la suite d’une téléconsultation en ORL pendant le confinement mondial. L’objectif secondaire était d’identifier des facteurs prédictifs de la satisfaction globale des patients. Résultats 125 patients ont été vu en téléconsultation sur une période de 7 jours d’inclusion et 100 patients ont complété le questionnaire. Le taux de satisfaction globale était de 87 %. Aucun facteur prédictif cliniquement pertinent n’était associé de façon statistiquement significative avec la satisfaction. Respectivement 76 et 61 % des patients avaient jugé satisfaisante la qualité du son et de la vidéo sans impact significatif sur leur satisfaction globale (respectivement OR = 3,40 ; valeur de p = 0,049 et OR = 3,79 ; valeur de p = 0,049). L’absence d’examen physique n’était pas significativement corrélée à une diminution de la satisfaction globale (OR = 0,30 ; valeur de p = 0,027). Conclusion La téléconsultation ne permettait pas une prise en charge médicale complète mais en situation de pandémie, elle a été bien accueillie par les patients. Elle représentait un moyen simple de maintenir la continuité des soins médicaux tout en réduisant le risque de contamination par contact direct entre les patients et le personnel soignant.
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Noordzij R, Plocienniczak MJ, Brook C. Virtual scribing within otolaryngology during the COVID-19 pandemic and beyond. Am J Otolaryngol 2020; 41:102611. [PMID: 32580066 PMCID: PMC7301782 DOI: 10.1016/j.amjoto.2020.102611] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/16/2020] [Indexed: 12/14/2022]
Abstract
Within otolaryngology, scribes have been utilized as a means of increasing clinic efficiency and easing workload on physicians. During the COVID-19 pandemic, a majority of otolaryngology clinic appointments at academic institutions have been moved to telemedicine in order to limit interpersonal contacts. At the height of the pandemic, our institution has protocolized scribe participation from in-person to remote. Scribes have virtually participated in telemedicine appointments in an effort to facilitate documentation and enhance the patient-physician relationship. Beyond the pandemic, as patients start being evaluated in-person, the risk of contamination and spread through aerosol generating procedures has limited the number of ancillary support staff that can be present in the examination rooms. As such, virtual scribing from a separate location within the clinic has been deemed warranted. This paper documents the protocols on virtual scribing for both telemedicine and a hybrid approach for in-clinic appointments where high-risk procedures are being performed.
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Affiliation(s)
| | - Michal J Plocienniczak
- Boston University School of Medicine, Boston, MA, United States; Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston, MA, United States.
| | - Christopher Brook
- Boston University School of Medicine, Boston, MA, United States; Department of Otolaryngology - Head and Neck Surgery, Boston Medical Center, Boston, MA, United States
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50
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Lambertoni A, Gravante G, Battaglia P, Turri-Zanoni M, Castelnuovo P, Karligkiotis A. A "Forward Triage" Model in Telemedicine for Head and Neck Oncological Patients During the COVID-19 Era. EAR, NOSE & THROAT JOURNAL 2020; 100:16-18. [PMID: 32845737 PMCID: PMC7450205 DOI: 10.1177/0145561320948995] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Alessia Lambertoni
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, 19045University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Giacomo Gravante
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, 19045University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
| | - Paolo Battaglia
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, 19045University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.,Department of Biotechnology and Life Sciences, Head and Neck Surgery & Forensic Dissection Research center (HNS&FDRc), 19045University of Insubria, Varese, Italy
| | - Mario Turri-Zanoni
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, 19045University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.,Department of Biotechnology and Life Sciences, Head and Neck Surgery & Forensic Dissection Research center (HNS&FDRc), 19045University of Insubria, Varese, Italy
| | - Paolo Castelnuovo
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, 19045University of Insubria-Varese, ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy.,Department of Biotechnology and Life Sciences, Head and Neck Surgery & Forensic Dissection Research center (HNS&FDRc), 19045University of Insubria, Varese, Italy
| | - Apostolos Karligkiotis
- Division of Otorhinolaryngology, Department of Surgical Specialties, 472719ASST Sette Laghi, Ospedale di Circolo e Fondazione Macchi, Varese, Italy
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