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1.
J Gen Intern Med ; 2023 Jan 17.
Article in English | MEDLINE | ID: covidwho-2174898

ABSTRACT

BACKGROUND: The Covid-19 pandemic dramatically changed healthcare delivery, driving rapid expansion of synchronous (i.e., real-time) audio-only and video telehealth, otherwise known as virtual care. Yet evidence describes significant inequities in virtual care utilization, with certain populations more dependent on audio-only virtual care than video-based care. Research is needed to inform virtual care policies and processes to counteract current inequities in access and health outcomes. OBJECTIVE: Given the importance of incorporating equity into virtual care within the Veterans Health Administration (VHA), we convened a Think Tank to identify priorities for future research and virtual care operations focused on achieving equitable implementation of virtual care within the VHA. METHODS: We used participatory activities to engage clinicians, researchers, and operational partners from across the VHA to develop priorities for equitable implementation of virtual care. We refined priorities through group discussion and force-ranked prioritization and outlined next steps for selected priorities. KEY RESULTS: Think Tank participants included 43 individuals from the VHA who represented diverse geographical regions, offices, and backgrounds. Attendees self-identified their associations primarily as operations (n = 9), research (n = 28), or both (n = 6). We identified an initial list of 63 potential priorities for future research and virtual care operations. Following discussion, we narrowed the list to four priority areas: (1) measure inequities in virtual care, (2) address emerging inequities in virtual care, (3) deploy virtual care equitably to accommodate differently abled veterans, and (4) measure and address potential adverse consequences of expanded virtual care. We discuss related information, data, key partners, and outline potential next steps. CONCLUSIONS: This Think Tank of research and operational partners from across the VHA identified promising opportunities to incorporate equity into the design and implementation of virtual care. Although much work remains, the priorities identified represent important steps toward achieving this vital goal.

2.
Arch Phys Med Rehabil ; 101(12): 2233-2242, 2020 12.
Article in English | MEDLINE | ID: covidwho-878828

ABSTRACT

Recognizing a need for more guidance on the coronavirus disease 2019 (COVID-19) pandemic, members of the Archives of Physical Medicine and Rehabilitation Editorial Board invited several clinicians with early experience managing the disease to collaborate on a document to help guide rehabilitation clinicians in the community. This consensus document is written in a "question and answer" format and contains information on the following items: common manifestations of the disease; rehabilitation recommendations in the acute hospital setting, recommendations for inpatient rehabilitation and special considerations. These suggestions are intended for use by rehabilitation clinicians in the inpatient setting caring for patients with confirmed or suspected COVID-19. The text represents the authors' best judgment at the time it was written. However, our knowledge of COVID-19 is growing rapidly. The reader should take advantage of the most up-to-date information when making clinical decisions.


Subject(s)
COVID-19/rehabilitation , Physical and Rehabilitation Medicine/organization & administration , COVID-19/physiopathology , Communication , Cooperative Behavior , Humans , Infection Control/standards , Inpatients , Patient Care Team/organization & administration , Physical and Rehabilitation Medicine/standards , Practice Guidelines as Topic , SARS-CoV-2 , Triage/standards
4.
Arch Phys Med Rehabil ; 101(6): 1068-1071, 2020 06.
Article in English | MEDLINE | ID: covidwho-8747

ABSTRACT

With the novel coronavirus 2019 (2019-nCoV) pandemic spreading quickly in the United States and the world, it is urgent that the rehabilitation community quickly understands the epidemiology of the virus and what we can and must do to face this microbial adversary at the early stages of this likely long global pandemic. The 2019-nCoV is a novel virus so most of the world's population does not have prior immunity to it. It is more infectious and fatal than seasonal influenza, and definitive treatment and a vaccine are months away. Our arsenal against it is currently mainly social distancing and infection control measures.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Rehabilitation/methods , Rehabilitation/organization & administration , Betacoronavirus , COVID-19 , Communication , Coronavirus Infections/prevention & control , Humans , Infection Control , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Risk Factors , SARS-CoV-2
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