Advancing Access to Healthcare through Telehealth: A Brownsville Community Assessment.

(1) Background: This paper focuses on the development of a community assessment for telehealth using an interprofessional lens, which sits at the intersection of public health and urban planning using multistakeholder input. The paper analyzes the process of designing and implementing a telemedicine plan for the City of Brownsville and its surrounding metros. (2) Methods: We employed an interprofessional approach to CBPR which assumed all stakeholders as equal partners alongside the researchers to uncover the most relevant and useful knowledge to inform the development of telehealth community assessment. (3) Results: Key findings include that: physicians do not have the technology, financial means, or staff to provide a comprehensive system for telemedicine; and due to language and literacy barriers, many patients are not able to use a web-based system of telemedicine. We also found that all stakeholders believe that telehealth is a convenient tool that has the capacity to increase patient access and care. (4) Conclusions: Ultimately, the use of an interprofessional community-based participatory research (CBPR) design allowed our team to bring together local knowledge with that of trained experts to advance the research efforts.

The Benefits and Challenges of Virtual Education for Interprofessional Teams in a Post-COVID Environment.

There have been a series of disruptions in the healthcare environment since 2019, starting with the global pandemic [...].

Unintended Consequences of a Transition to Synchronous, Virtual Simulations for Interprofessional Learners.

The coronavirus pandemic shifted in-person environments to virtual environments. Little is known about the effectiveness of fully synchronous, virtual interprofessional education (IPE). This study aims to compare two IPE cases that occurred in-person pre-pandemic and virtual during-pandemic. Two cases are analyzed: a medical error care and a charity care case. Participants were students from various health science disciplines. Assessments were captured through The Interprofessional Collaborative Competency Attainment Survey (ICCAS). Effect sizes were calculated for the pre-and post-surveys and analyzed using Cohen's d for independent samples. From the in-person collection period, a total of 479 students participated in the medical error simulation and 479 in the charity care simulation. During the virtual collection period, a total of 506 students participated in the medical error simulation and 507 participated in the charity care simulation. In the data for the virtual simulations, the medical error case study maintained a large effect size (0.81) while the charity care simulation had a lesser impact (0.64 effect size). Structural details of the patient cases may be a critical variable. Future research is needed to better understand how health science students can obtain more training to notice the subtle cues from patients assessed through telemedicine modalities.

The Impact of COVID-19 on Opioid-Related Overdose Deaths in Texas.

Prior to the COVID-19 pandemic, the United States was facing an epidemic of opioid overdose deaths, clouding accurate inferences about the impact of the pandemic at the population level. We sought to determine the existence of increases in the trends of opioid-related overdose (ORO) deaths in the Greater Houston metropolitan area from January 2015 through December 2021, and to describe the social vulnerability present in the geographic location of these deaths. We merged records from the county medical examiner's office with social vulnerability indexes (SVIs) for the region and present geospatial locations of the aggregated ORO deaths. Time series analyses were conducted to determine trends in the deaths, with a specific focus on the years 2019 to 2021. A total of 2660 deaths were included in the study and the mean (standard deviation, SD) age at death was 41.04 (13.60) years. Heroin and fentanyl were the most frequent opioids detected, present in 1153 (43.35%) and 1023 (38.46%) ORO deaths. We found that ORO deaths increased during the years 2019 to 2021 (p-value ≤ 0.001) when compared with 2015. Compared to the year 2019, ORO deaths increased for the years 2020 and 2021 (p-value ≤ 0.001). The geographic locations of ORO deaths were not associated with differences in the SVI. The COVID-19 pandemic had an impact on increasing ORO deaths in the metropolitan Houston area; however, identifying the determinants to guide targeted interventions in the areas of greatest need may require other factors, in addition to community-level social vulnerability parameters.

Dramatic Increases in Telehealth-Related Tweets during the Early COVID-19 Pandemic: A Sentiment Analysis.

The COVID-19 pandemic resulted in a large expansion of telehealth, but little is known about user sentiment. Tweets containing the terms "telehealth" and "telemedicine" were extracted (n = 192,430) from the official Twitter API between November 2019 and April 2020. A random subset of 2000 tweets was annotated by trained readers to classify tweets according to their content, including telehealth, sentiment, user type, and relation to COVID-19. A state-of-the-art NLP model (Bidirectional Encoder Representations from Transformers, BERT) was used to categorize the remaining tweets. Following a low and fairly stable level of activity, telehealth tweets rose dramatically beginning the first week of March 2020. The sentiment was overwhelmingly positive or neutral, with only a small percentage of negative tweets. Users included patients, clinicians, vendors (entities that promote the use of telehealth technology or services), and others, which represented the largest category. No significant differences were seen in sentiment across user groups. The COVID-19 pandemic produced a large increase in user tweets related to telehealth and COVID-19, and user sentiment suggests that most people feel positive or neutral about telehealth.

Telehealth sustains patient engagement in OUD treatment during COVID-19.

The coronavirus disease pandemic of 2019 (COVID-19) has created significant economic and societal burden, with mortality currently exceeding 615,000 and millions of others affected worldwide. For those with opioid use disorder (OUD), however, the impact on this vulnerable population could be even more severe. The objective of this study was to outline our organizational telehealth adaptations that enabled virtual counseling, peer support, groups, and provider care during COVID-19 in one community-based opioid treatment program. We utilized an observational study design during March to June 2020, during the initial peak of COVID-19 in the U.S. After we closed our facility for the first five business days, we rapidly enacted virtual care with telehealth for peer coaching, counseling, groups, and provider visits. While we lost patient volume during the initial weeks, we observed an overall increase in patient engagement over time. Future state and federal policy should focus on maintaining less stringent policies around the use of telehealth, prescribing, and in-person exams for medication for OUD.