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Alkawaldeh M, Alkhawaldeh A, Yeboah T. Exploring patients' experiences with telehealth in obstetrics care during the COVID-19 pandemic: A qualitative study. PLoS One 2023; 18:e0292799. [PMID: 38117846 PMCID: PMC10732431 DOI: 10.1371/journal.pone.0292799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 09/28/2023] [Indexed: 12/22/2023] Open
Abstract
AIM The aim of this study was to evaluate patients' experiences with telehealth provision of obstetrics and gynecology care during the COVID-19 pandemic qualitatively. DESIGN AND SETTING In this study, a qualitative research design, namely descriptive phenomenology, was employed. Participants were recruited from the OB department at UMass Memorial Medical center in Worcester, MA, between 6/2020 and 7/2020. METHODS Between June 2020 and July 2020, in-depth interviews were conducted with 18 women receiving care at the Obstetrics and Maternal and Fetal Medicine clinics. Data were analyzed using qualitative thematic analysis, as outlined by Braun and Clarke. RESULTS Telehealth is a feasible and safe health-care tool that is available during these unprecedented times. This study provided qualitative evidence based on patients' perspectives and experiences. Participants' meanings in relation to their experiences of using telehealth services emerged from the data in four themes: the overall experience of using modern telehealth platforms, telehealth and its perceived benefits, telehealth and its perceived challenges, and telehealth and its potential future use. CONCLUSION While this study highlights areas in telehealth implementation that require improvement, the overall positive experiences and consistent perceived benefits of most participants suggests that telehealth can be an important tool in healthcare delivery for appropriate patients and situations moving forward in a post-pandemic world. IMPACT During the global pandemic, telehealth has been recognized to have the potential to play a critical role in healthcare delivery. Establishing qualitative evidence-based practices in the emerging field of telehealth for OB services is pivotal to mitigate potential safety, feasibility, and cost issues that could be associated with the rapid adoption of telehealth. Yet, this qualitative study However highlighted several challenges that are necessary to be addressed in order for telehealth to meet maximum effectiveness and functionality in the future.
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Affiliation(s)
| | - Asma Alkhawaldeh
- Research Specialist, Jordanian Royal Medical Services, Amman, Jordan
| | - Tracy Yeboah
- Department of OBGYN, Research Coordinator, University of Massachusetts Medical School, Worcester, MA, United States of America
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Desai P, Kazmi SH, Schneider S, Angert R. Virtual Care Across the Neonatal Intensive Care Continuum. Cureus 2023; 15:e35183. [PMID: 36960267 PMCID: PMC10029832 DOI: 10.7759/cureus.35183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2023] [Indexed: 02/21/2023] Open
Abstract
The ongoing coronavirus disease 2019 (COVID-19) pandemic has highlighted the need for establishing effective parent and family engagement throughout all aspects of medicine. Though there has been some discussion in the literature regarding the transition from typical outpatient visits to telehealth visits, there has been less written about the inpatient approach to family inclusion. Here, we seek to describe our institution's experience with implementing virtual medicine across the full continuum of the neonatal intensive care unit (NICU) experience, including inpatient rounding, child life family visits, and outpatient high-risk developmental follow-up after discharge.
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Affiliation(s)
- Purnahamsi Desai
- Pediatrics, New York University (NYU) Grossman School of Medicine, New York, USA
| | - Sadaf H Kazmi
- Pediatrics, New York University (NYU) Grossman School of Medicine, New York, USA
| | - Stacey Schneider
- Child Life, New York University (NYU) Langone Health, New York, USA
| | - Robert Angert
- Pediatrics, New York University (NYU) Grossman School of Medicine, New York, USA
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Shamsabadi A, Dashti M, Ghasemzadeh A, Mehraeen E, Saber Mashhad Taraqi A, Jalali A, Pashaei Z, Pashaei A. Virtual clinic in pregnancy and postpartum healthcare: A systematic review. Health Sci Rep 2022; 6:e970. [PMID: 36570344 PMCID: PMC9768841 DOI: 10.1002/hsr2.970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 10/31/2022] [Accepted: 11/17/2022] [Indexed: 12/24/2022] Open
Abstract
Background and Aims To monitor the health status of pregnant women moment by moment, new technologies in the field of telemedicine can be used, such as virtual visits and virtual clinics. During the COVID-19 pandemic, by using these technologies, useful and satisfactory services have been provided to pregnant mothers. The aim of this study is to specify the applications, features, and infrastructure of a comprehensive virtual clinic in the field of gynecological and pregnancy care. Methods A systematic review search was conducted through the scientific databases from February 2013 to February 2022 using Scopus, Web of Science, and PubMed. Furthermore, manual searches in Google Scholar and the reference lists of included studies were carried out. Results In this systematic review we included 16 articles that reported experiences in virtual clinics in pregnancy and postpartum healthcare. The involved studies were experimental, cohort, and cross-sectional studies. The target group users were pregnant or women who gave birth and families of neonatal. The application of virtual clinics was for the visit, consultation, monitoring, follow-up, and home care virtually. Highly satisfaction scores of caregivers after virtual visits and consultation were reported. There were some challenges during virtual visits and consultation; the most important challenge was a poor internet connection. Conclusion The reviewed studies show promising outcomes according to patient and provider satisfaction. We predict that telehealth will become a growingly significant part of gynecological care in the future.
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Affiliation(s)
- Ahmadreza Shamsabadi
- Department of Health Information TechnologyEsfarayen Faculty of Medical ScienceEsfarayenIran
| | - Mohsen Dashti
- Department of RadiologyTabriz University of Medical SciencesTabrizIran
| | | | - Esmaeil Mehraeen
- Department of Health Information TechnologyKhalkhal University of Medical SciencesKhalkhalIran
| | - Ashraf Saber Mashhad Taraqi
- Instructor of Midwifery Education, School of Medical SciencesEsfarayen Faculty of Medical SciencesEsfarayenIran
| | - Aliakbar Jalali
- Faculty of Mechanical EngineeringUniversity of TehranTehranIran
| | - Zahra Pashaei
- School of NursingUniversity of British ColumbiaVancouverCanada,Iranian Research Center for HIV/AIDSTehran University of Medical SciencesTehranIran
| | - Alireza Pashaei
- Faculty of Electrical and Computer EngineeringUniversity of TabrizTabrizIran
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Chuo J, Makkar A, Machut K, Zenge J, Jagarapu J, Azzuqa A, Savani RC. Telemedicine across the continuum of neonatal-perinatal care. Semin Fetal Neonatal Med 2022; 27:101398. [PMID: 36333212 PMCID: PMC9623499 DOI: 10.1016/j.siny.2022.101398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- John Chuo
- Division of Neonatology, Department of Pediatrics, University of Pennsylvania, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Abhishek Makkar
- Division of Newborn Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center; Oklahoma City, Oklahoma, USA
| | - Kerri Machut
- Division of Neonatology, Department of Pediatrics, Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Jeanne Zenge
- Section of Neonatology, Department of Pediatrics, University of Colorado School of Medicine and Children's Hospital of Colorado, Aurora, CO, USA
| | - Jawahar Jagarapu
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Abeer Azzuqa
- Division of Newborn Medicine, Department of Pediatrics, University of Pittsburgh School of Medicine and UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Rashmin C. Savani
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, TX, USA
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Reid CN, Marshall J, Fryer K. Evaluation of a Rapid Implementation of Telemedicine for Delivery of Obstetric Care During the COVID-19 Pandemic. Telemed J E Health 2022; 28:1672-1681. [PMID: 35426743 DOI: 10.1089/tmj.2021.0539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: The aim of this evaluation was to assess the rapid implementation of obstetric telemedicine during the COVID-19 pandemic using the Consolidated Framework in Implementation Research (CFIR) evaluation framework. Study Design: Following 1 month of telemedicine implementation, obstetric providers at the University of South Florida clinic completed qualitative surveys and in-depth interviews about the implementation of obstetric telemedicine in the clinic guided by the CFIR evaluation framework. Results: Overall, providers considered obstetric telemedicine comparable to traditional in-person clinic visits and acknowledged that they were adequately prepared for the telemedicine implementation. They perceived that obstetric telemedicine mostly met the needs of patients in terms of convenience and comfort of visits, decreased exposure to COVID-19 infection, and the ability of the patient to listen to fetal heart sounds if at-home doppler monitoring was available. Conclusions: The implementation of the obstetric telemedicine care model was deemed a favorable alternative option for patients during the COVID-19 pandemic.
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Affiliation(s)
- Chinyere N Reid
- Chiles Center, College of Public Health University of South Florida, Tampa, Florida, USA
| | - Jennifer Marshall
- Chiles Center, College of Public Health University of South Florida, Tampa, Florida, USA
- Sunshine Education and Research Center, College of Public Health University of South Florida, Tampa, Florida, USA
| | - Kimberly Fryer
- Department of Obstetrics and Gynecology, University of South Florida, Tampa, Florida, USA
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Jagarapu J, Savani RC. Development and implementation of a teleneonatology program: Opportunities and challenges. Semin Perinatol 2021; 45:151428. [PMID: 34176650 DOI: 10.1016/j.semperi.2021.151428] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Teleneonatology, encompassing all telemedicine applications in neonatal medicine, is evolving with innovative applications for use in all aspects of neonatal care. In this chapter, we discuss the key components of and a framework for the development, implementation and evaluation of a program based on existing literature and our own program. We also review some important barriers to implementation and potential solutions. We hope that this review will serve as a guide for those seeking to develop and implement other new teleneonatology programs.
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Affiliation(s)
- Jawahar Jagarapu
- The Division of Neonatal-Perinatal Medicine, Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Rashmin C Savani
- The Division of Neonatal-Perinatal Medicine, Department of Pediatrics, The University of Texas Southwestern Medical Center, Dallas, TX, USA
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Abstract
Over a century of innovations in technology and medical care have led to the current day capabilities in telemedicine. In this chapter, we discuss the evolution of telemedicine over the last century and highlight various applications in neonatal care. We hope this chapter demonstrates the exponential adoption of telemedicine, particularly in neonatology, and the breadth and depth of the technology being used.
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Cena L, Rota M, Calza S, Massardi B, Trainini A, Stefana A. Estimating the Impact of the COVID-19 Pandemic on Maternal and Perinatal Health Care Services in Italy: Results of a Self-Administered Survey. Front Public Health 2021; 9:701638. [PMID: 34336776 PMCID: PMC8323996 DOI: 10.3389/fpubh.2021.701638] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 06/18/2021] [Indexed: 12/12/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is strongly changing the way most people live their lives, and disrupting specialist healthcare systems. Such public health disruptions have resulted in significant collateral damage with particular implications for vulnerable populations, including the perinatal population. This Study aims to estimate the impact of the COVID-19 pandemic on Italian maternal and perinatal health care services. A questionnaire was designed to evaluate the COVID-19 impact on Italian maternal and perinatal healthcare facilities and their activities and provision of services from March to May 2020. The survey was completed by hospital-based and community-based Italian maternal and perinatal healthcare facilities. Most of these were located in Lombardy or Veneto (the most affected Italian regions). 70% of all facilities reported that the first wave of the COVID-19 pandemic negatively influenced the functioning of one or more aspects of the perinatal service; only 28.4% of facilities all over the country continued to provide outpatient routine visits and examinations as usual; 23.4% of facilities became understaffed during the index period due to various reasons such as ward transfer and sick leave. This is the first Italian study, and among very few international studies that describe the effects of the COVID-19 pandemic on antenatal and postnatal healthcare facilities and their provision of activities and services. Our findings confirm that healthcare systems even in high-income countries were not entirely prepared to handle such a global health emergency; indeed, specialized maternal and perinatal healthcare services have been disrupted by this global health emergency.
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Affiliation(s)
- Loredana Cena
- Observatory of Perinatal Clinical Psychology, Section of Neuroscience, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Matteo Rota
- Units of Biostatistics and Biomathematics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Stefano Calza
- Units of Biostatistics and Biomathematics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Barbara Massardi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Alice Trainini
- Observatory of Perinatal Clinical Psychology, Section of Neuroscience, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Alberto Stefana
- Observatory of Perinatal Clinical Psychology, Section of Neuroscience, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
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Lapadula MC, Rolfs S, Szyld EG, Hallford G, Clark T, McCoy M, McKnight S, Makkar A. Evaluating Patients' and Neonatologists' Satisfaction With the Use of Telemedicine for Neonatology Prenatal Consultations During the COVID-19 Pandemic. Front Pediatr 2021; 9:642369. [PMID: 33748048 PMCID: PMC7966517 DOI: 10.3389/fped.2021.642369] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/10/2021] [Indexed: 11/18/2022] Open
Abstract
Background: During the COVID-19 pandemic, telemedicine plays a critical role in providing safe, effective healthcare services, while reinforcing social distancing and optimizing the use of personal protective equipment. In this context, the Oklahoma Children's Hospital implemented virtual neonatology prenatal visits for pregnant women with a diagnosis of fetal anomalies. While tele-consultations have been broadly used with a high degree of acceptance in rural and remote areas, satisfaction has not been assessed in this particular scenario, where patients and physicians discussing sensitive healthcare information had to rapidly adjust to this new modality. Objectives: To evaluate patients' and neonatologists' satisfaction with virtual prenatal consultations in the context of the COVID-19 pandemic and to compare satisfaction levels of patients receiving virtual consultation with those receiving in-person consults. Methods: This cross-sectional study evaluated patients' and neonatologists' satisfaction with virtual consultations. Participants included pregnant women with diagnosis of fetal anomalies who received neonatology prenatal consultations at Oklahoma Children's Hospital, either in-person or through telemedicine, from May to mid-November 2020, and neonatologists providing virtual prenatal consultations in the same period. Virtual visits were delivered via Zoom Pro™. Patients and physicians who agreed to participate rated acceptability completing an anonymous 5-point Likert scale survey. Item frequencies and means for categories of items were computed by group (video-consult patients, in-person patients, physicians) and analyzed, using Welch's t for unequal sample size. Results: Overall consultation quality was rated good or excellent by 35 (100%) video-consult patients and 12 (100%) in-person patients. Patient group means computed on six 5-point Likert items about patient-physician communication did not differ significantly, video-consult: M = 28.71 (2.22); in-person consult: M = 28.92 (1.78) (p = 0.753263). All eight physicians (100%) agreed or strongly agreed that telemedicine was effective, using a 5-point Likert scale, and their combined consultation quality score computed on 10 survey questions was high: M = 46.4 (3.11). Conclusion: Despite patient inexperience with tele-consultations, the quick implementation of telemedicine, and the sensitive reason for the visit, patients and physicians were highly satisfied with virtual visits. Telemedicine is a safe, effective alternative for providing neonatology prenatal consultations for pregnant women with diagnosis of fetal anomalies during the pandemic.
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Affiliation(s)
- Maria C Lapadula
- Division of Newborn Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Shanna Rolfs
- University of Oklahoma College of Medicine, Oklahoma City, OK, United States
| | - Edgardo G Szyld
- Division of Newborn Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Gene Hallford
- Division of Newborn Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Tracie Clark
- Division of Newborn Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Mike McCoy
- Division of Newborn Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Stephanie McKnight
- Division of Newborn Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Abhishek Makkar
- Division of Newborn Medicine, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
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