A Privacy Paradox? Impact of Privacy Concerns on Willingness to Disclose COVID-19 Health Status in the United States

Privacy concerns around sharing personal health information are frequently cited as hindering COVID-19 contact tracing app adoption. We conducted a nationally representative survey of 304 adults in the United States to investigate their attitudes towards sharing two types of COVID-19 health status (COVID-19 Diagnosis, Exposure to COVID-19) with three different audiences (Anyone, Frequent Contacts, Occasional Contacts). Using the Internet User's Information Privacy Concern (IUIPC) scale, we were able to identify the effect of different types of privacy concerns on sharing this information with various audiences. We found that privacy concerns around data Collection predicted lower willingness to share either type of health status to all of these audiences. However, desire for Control and for Awareness of data practices increased willingness to share health information with certain audiences. We discuss the implications of our findings. © 2022 Owner/Author.

Neuromodulation Virtual Care Technology Provides Safe and Effective Drg/Scs Remote Programming: E-Poster Viewing

Introduction: About 20.4% of US adults suffer from chronic pain and need consistent management plans which were disrupted in 2020 with the COVID-19 pandemic.1,2,3 Patients who use programmable neuromodulation devices to treat chronic pain typically require follow-up visits to address changes in symptoms. An FDA-approved teleprogramming platform enables real-time remote programming via mobile devices for movement disorder and chronic pain patients who use neuromodulation devices. The platform eases the burden travel imposed on many patients, allowing physicians to quickly resolve patient symptoms. The Remote Optimization, Adjustment, and Measurement for Chronic Pain Therapy (ROAM-CPT) study is a post-market, prospective, non-randomized, multi-center investigation to determine that the telehealth system meets patients' therapeutic needs safely and effectively. Materials / Methods: 62 consented subjects across 4 sites, with an implanted neuromodulation device, participating in the REALITY study (NCT03876054) were enrolled in ROAM-CPT and were provided access to the telehealth software. A questionnaire designed for both patient and physician was available after each remote session. The primary success rate was determined by the ability to establish an audio-video connection, complete remote programming or device check, and provide patient clinical care similar to an in-patient session. Additionally, the physicians' and patients' preferences, satisfaction, and reduction in the burden of care compared to in-person sessions were determined. Result(s): 15 patients initiated and completed an audio-video session. All physicians' confirmed services are akin to in-person sessions. During the study, 53.3% of the sessions were complex programming (change in three or more parameters), 26.7% simple programming (change in 1-2 parameter), and 20.0% device interrogation. Overall, all surveyed providers preferred remote care and 93.3% (14/15) of subjects did not require additional clinical care services. Of the 15 subjects across 4 sites, all but 1 reported rapid resolution (reduction in pain), preferred remote care to in-patient, and would recommend a remote session. Patients also reported getting faster appointment time as well as saving travel time and resources typically spent towards an in-person session. Discussion(s): The remote neuromodulation technology provides secure audio-video chat connectivity, programming changes such as amplitude, systems check, and session reports. Physicians easily provide patients care using this platform while patients' therapeutic needs were quickly resolved from the comfort of their homes using their mobile devices. Conclusion(s): Teleprogramming provides real-time programming capabilities and optimizes therapy for patients with neurostimulation devices. Learning Objectives: 1. Teleprogramming provides real-time, safe programming that equals an in-person session. No safety concerns were recorded for all 15 session 2. Virtual clinic affords clinicians the ability to provide quick patient care, does not increase the need for additional follow-up. All 15 participating patients reported resolved therapy needs. 14/15 did not require additional follow-up. 3. Physicians and patients both prefer Virtual clinic 4/4 surveyed physicians and 14/15 surveyed patients preferred virtual clinic. Keywords: Teleprogramming, Neuromodulation, Neurosphere, Virtual clinic, Remote programming, Telehealth Copyright © 2022

Assessment of Bedside Teaching in a Tertiary Care Academic Medical Intensive Care Unit

Introduction Reportedly, teaching at the bedside is declining over time. This purported decline has not been quantified. Quantifying bedside teaching is challenging, and we found only one study quantifying bedside teaching on a hospitalist service. We conducted a study to understand the prevalence of bedside teaching in our medical intensive care unit. Methods We conducted a single-center single-unit study in the medical intensive care unit of an academic tertiary care institution. We utilized a survey tool to assess perceived time spent on bedside teaching, quality of teaching, and total rounding time. In parallel, independent observers objectively measured time spent on rounds and on bedside teaching. Residents were asked to complete the survey once a week. Independent observers collected data daily and weekly averages were obtained. Results A total of 43 responses were collected over a 4-month period. Most respondents (73%) reported a total rounding time of either 90-120 min or greater than 120 min. Median reported bedside teaching time was 16-20 min with 16 respondents (37%) reporting less than 15 min and 27 respondents (63%) reporting 16 min or more. The amount of time spent on bedside teaching was reported as adequate or more than adequate by 77% (33) of respondents with 58% (25) reporting that bedside teaching was very or extremely effective in helping them learn. The mean census reported by the independent observers was 12.75 patients per team. Bedside teaching represented an average of 12% of total rounding time, 16.85 minutes per day. There was no correlation between the team census and the amount of bedside teaching. While total rounding time increased with increasing census, there was no decline in bedside teaching time. Discussion/Conclusion Medical education has evolved over time and has gradually incorporated informal teaching sessions, simulations, and mini lectures in addition to traditional bedside teaching. Despite the evolution in medical education, bedside teaching remains an integral component of post graduate medical education. Even though bedside teaching represented only 12% of total rounding time, medical residents perceived the time and quality of bedside teaching to be adequate. Strengths: Bedside teaching time was corroborated by independent observers and not limited to subjective perception of trainees. Limitations: This study was limited to one medical intensive care unit in an academic tertiary care hospital. This study was conducted during the COVID-19 pandemic which may have affected results. A small number of surveys were collected over a 4-month period. (Figure Presented).

Launching chat service during the pandemic: inaugurating a new public service under emergency conditions

Purpose: This article details the implementation of a live online chat service which was suddenly necessitated by the worldwide coronavirus disease 2019 (COVID-19) pandemic. The approaches used to train chat operators during this time inform both current and future training initiatives toward continuous improvement in this academic library setting. Design/methodology/approach: Chat transcripts from the period of March 2020–April 2021 serve as the dataset for this study. Findings: In bringing a live chat service online during a global pandemic, chat transcripts from this period reveal 19.3% of all chat interactions related directly to COVID-19. The transcripts also reveal the types of questions, whether reference or directional, and these, combined with staffing patterns, indicate that staff were addressing reference questions more often than librarians. In addition, 25.2% of all transactions, whether by staff or librarians, resulted in tickets or referrals to hand off the question to a subject or functional specialist. These findings help to inform targeted face-to-face refresher training for chat operators. Originality/value: While bringing a live chat service online is certainly not novel, the impetus behind the quick setup was. This unusual circumstance allowed for an in-depth look at the nature of chat and its training requirements and limitations due to campus stay-at-home orders. It also provided a new understanding that influenced subsequent face-to-face trainings. © 2021, Emerald Publishing Limited.

Experiences of virtual cystic fibrosis clinics during the COVID-19 pandemic at one UK adult cystic fibrosis centre

Background: In response to the COVID-19 pandemic, the Oxford Adult CF Centre offered virtual clinics using the NHS Attend Anywhere platform from June 2020. We surveyed patient and staff experience. Methods: An anonymous online patient survey was added to appear at the end of all CF virtual consultations from July to November 2020. A separate anonymous staff survey was distributed by email to all members of the CF multidisciplinary team. Results: 136 responses were received (patient population of 141) and 12/19 (62%) of staff responded. 71% of patients rated a virtual review a very reasonable alternative to face-to-face and 83% felt all their clinical needs were met. 98% rated how comfortable they were to talk to clinicians as 4 or 5/5. 83% staff felt they could provide an acceptable standard of review to most patients. When asked if they could provide a high standard of review, 17% felt they could to most patients, with 58% feeling they could to some patients only. Time efficiency and patient attendance at virtual clinics were perceived as superior to face-to face. 86% of patients rated their satisfaction with the technology as 4 or 5/5, with 100% staff rating as 4/5. 11 negative patient comments related to technology. Poor sound quality and video lag were the main concerns identified by both patients and staff. 82% of patients would like to continue using virtual reviews in future and 100% staff wanted this to be an option for some appointments. Routine clinic visits were rated most popular appointments to be virtual in future by staff and patients. Conclusion: Virtual clinics have been well received by the majority of our adult CF patients during the COVID-19 pandemic. Patients and staff wanted to use virtual reviews in future, although both recognised this is not always suitable for all appointments.

142 Improving Functional Outcomes During Covid-19 for Both COVID-19 and Non COVID-19 Positive Older Adults Through the Introduction

Purpose To improve the functional outcomes of older adults presenting to the Health and Ageing wards during the COVID-19 pandemic through a focussed rehabilitation list. The intended benefits to the older adult and service were for: 1. Daily rehabilitation input for older adults. 2. Older adults to spend less time immobile. 3. Ongoing rehabilitation intervention while awaiting medical clearance for discharge. 4. Increased staff satisfaction 5. Better outcomes on discharge. 6. Rehabilitation ethos on the Health and Ageing wards. Methods The quality improvement project was carried out using the Plan, Do, Study, Act (PDSA) cycle. Three iterative PDSA cycles were carried out over the course of the project to deliver proactive interventions as a result of analysis of baseline data and stakeholder involvement. These interventions were aimed at developing communication around the rehabilitation list within the team and sustainability of this list. Results The project resulted in better functional outcomes for older adults and increased staff morale. Between May 2020–June 2020, a total of 56 patients were seen on the rehabilitation list, with 84% of these patients seeing improvements in their Elderly Mobility Scores (EMS). 27% of patients on the rehabilitation list saw a change to their initial discharge plan, either needing reduced packages of care or reduced need for ongoing rehabilitation in an external setting. Conclusions The quality improvement project found that with focussed rehabilitation older adult inpatients with or without COVID-19 can make significant functional gains. These gains have wider effects on their outcomes on discharge and also for the service through increased morale and job satisfaction. Due to demand and capacity issues in the acute setting, older adults who would often benefit from ongoing input are not always reviewed regularly. This project demonstrates that with focussed rehabilitation older adults can improve and achieve better functional outcomes.