The Future of Telehealth for Allergic Disease.

The COVID-19 pandemic created an explosion in the use of telehealth. However, telehealth consists of much more than a video discussion between doctor and patient. Since the onset of the COVID-19 pandemic, allergists have demonstrated a high level of synchronous telemedicine adoption with existing patients but have not taken full advantage of other virtual care modalities that have the potential to facilitate the efficient delivery of allergy care to the broader population. This is partially due to a lack of awareness about the various remote care services and how to implement and bill for them appropriately. This rostrum describes the spectrum of telehealth services, reviews existing literature on the use of telehealth in allergy, and provides suggestions about how allergists and immunologists can optimize the use of telehealth to optimize patient access and outcomes as well as receive appropriate compensation for specialty clinical services provided by themselves and their staff.

Virtual Palliative Care Is Inclusive Care (QI408)

Outcomes 1. Describe a national virtual palliative care approach to increasing access to services for patients living with serious illness during the COVID-19 pandemic 2. Examine virtual palliative care utilization patterns in the inpatient and outpatient setting as well as the adoption of telephonic or video-based platforms 3. Recognize palliative care clinician perspectives and willingness to adopt virtual visits across the care continuum Background The number of Americans who are living with serious illness without adequate access to palliative care services is growing. Virtual palliative care offers an inclusive solution that enhances the patients’ quality of life and addresses complex patient centric needs. Aim Statement This project was developed during the COVID-19 pandemic to investigate telehealth utilization and engagement as well as clinician perceptions and experiences using the virtual platform. Methods We evaluated the use of telephone and video visits in 7 states from May 2020 to April 2021. Of the 84 palliative care clinicians (physicians and APPs) practicing in those states, 35 clinicians (42%) conducted virtual visits. A total of 1,816 virtual visits were completed based on claims analysis. We conducted a clinician experience survey that was completed via Google forms by 15 physicians (44% response rate), which provided qualitative feedback. Results Of the 1,816 visits completed, 332 were telephonic and 1,484 video. 30% of the visits were from the inpatient setting, 19% nursing facility, and 51% outpatient. Top diagnoses were respiratory failure, neuro/Parkinson's, dementia, CHF, and cancer. 37% of the patients lived in disadvantaged zip codes. 93% of the clinicians who responded to the survey were open to having a video visit with their patients with reported benefits such as improved access to care, more efficient use of time, and enhanced clinician-patient relationship. The barriers reported by clinicians included patients having limited availability to a device with a camera and inadequate internet bandwidth. Conclusions and Implications Clinicians find virtual palliative care to be beneficial to patients for goals-of-care conversations, frequent symptom assessment, and engaging multiple family members. Despite a perception that video visits have low adoption in older populations, more than 68% of the virtual visits were with patients 65 years+. These findings have strong implications for clinical practice transformation and further study in the field of virtual palliative care.

Conducting a Professional Telemedicine Visit Using High-Quality Webside Manner

Purpose of Review As telemedicine gains popularity among providers and patients alike, it is important to ensure the standards of care remain equivalent between the in-person and virtual settings. While bedside manner remains a key competency incorporated into medical school curricula, “webside manner,” or professional standards for virtual care, remains less defined. Recent Findings Best practices exist including guidance prior to the visit, methods to maintain a professional background environment, and translation of core communication competencies for a video interaction. Through application of these practices, a provider can ensure the core interpersonal and communication competencies are fulfilled. These practices have direct application to allergy, asthma, and immunology care. Summary This review provides an overview of best practices for professionalism and patient interaction for virtual care and examines specific applications to allergy, asthma, and immunology visits

Analysis of COVID-19 vaccine non-intent by essential vs non-essential worker, demographic, and socioeconomic status among 101,048 US adults.

As of May 2021, over 286 million coronavirus 2019 (COVID-19) vaccine doses have been administered across the country. This data is promising, however there are still populations that, despite availability, are declining vaccination. We reviewed vaccine likelihood and receptiveness to recommendation from a doctor or nurse survey responses from 101,048 adults (≥18 years old) presenting to 442 primary care clinics in 8 states and the District of Columbia. Occupation was self-reported and demographic information extracted from the medical record, with 58.3% (n = 58,873) responding they were likely to receive the vaccine, 23.6% (n = 23,845) unlikely, and 18.1% (n = 18,330) uncertain. We found that essential workers were 18% less likely to receive the COVID-19 vaccination. Of those who indicated they were not already "very likely" to receive the vaccine, a recommendation from a nurse or doctor resulted in 16% of respondents becoming more likely to receive the vaccine, although certain occupations were less likely than others to be receptive to recommendations. To our knowledge, this is the first study to look at vaccine intent and receptiveness to recommendations from a doctor or nurse across specific essential worker occupations, and may help inform future early phase, vaccine rollouts and public health measure implementations.