ABSTRACT
Background: Telemedicine use has expanded rapidly during the COVID-19 pandemic. There is limited data on patient satisfaction with teledermatology;therefore, we examined patient teledermatology experiences at a large academic center. Methods: After Weill Cornell Medicine Institutional Review Board approval, patients scheduled for teledermatology visits (1/2021-4/2021) were enrolled and sent pre/postconsultation questionnaires about telemedicine satisfaction, expectations, and concerns (5-point Likert scale) (82% response rate). Results: Of 202 participants, 120 (59%) were female with mean age 49 years. Participants were largely White (78%) and non-Hispanic (86%). The majority had at least a college degree (94%) and were employed (66%). Younger patients (21-40) were more satisfied with telemedicine (P =.016), and its convenience (P =.001), compared with older participants (>66) (P =.001, P =.019). Those with shorter travel times (<30 min) preferred in-person visits (P =.031). Nonwhite race was associated with greater concerns for conversation privacy and inappropriate information access (both P =.004). White race was associated with greater confidence in telemedicine diagnosis (P =.032). Participants had less trouble hearing and seeing than anticipated (P ≤.001 and P =.005). Patients were more interested in using telemedicine and preferred it over in-person appointments post- vs. preconsultation (P<.001 both). Conclusion: Our study demonstrates overall positive attitudes towards teledermatology. However, decreased satisfaction and confidence were found amongst older and nonwhite patients. Patients with longer vs. shorter clinic proximity preferred telemedicine to in-person visits, which may improve access to care in areas without dermatologists. Our study clarified specific concerns that may be used to devise strategies to encourage universal utilization of teledermatology where appropriate.
ABSTRACT
The novel coronavirus, COVID-19, created a pandemic with significant mortality and morbidity which poses challenges for patients and healthcare workers. The global spread of COVID-19 has resulted in shortages of personal protective equipment (PPE) leaving frontline health workers unprotected and overwhelming the healthcare system. 3D printing is well suited to address shortages of masks, face shields, testing kits and ventilators. In this article, we review 3D printing and suggest potential applications for creating PPE for healthcare workers treating COVID-19 patients. A comprehensive literature review was conducted using PubMed with keywords "Coronavirus disease 2019", "COVID-19", "severe acute respiratory syndrome coronavirus 2", "SARS-CoV-2", "supply shortages", "N95 respirator masks", "personal protective equipment", "PPE", "ventilators", "three-dimensional model", "three-dimensional printing""3D printing"and "ventilator". A summary of important studies relevant to the development of 3D-printed clinical applications for COVID-19 is presented. 3D technology has great potential to revolutionize healthcare through accessibility, affordably and personalization.
ABSTRACT
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has significantly affected clinical practices. Currently, elective dermatologic procedures (ablative laser procedure and laser hair removal) are deferred with only emergency dermatological surgeries being performed to lessen viral spread and preserve personal protective equipment (PPE). As COVID-19 prevalence decreases, postponed procedures will be scheduled. For Mohs micrographic surgery (MMS) and excisions, hemostasis is often achieved by electrosurgery, generating surgical smoke plume. Although data on transmission of SARS-CoV-2 via surgical smoke is unavailable, human immunodeficiency virus, hepatitis B virus, and human papillomavirus have been detected in surgical smoke. Since SARS-CoV-2 may be transmitted through aerosols, it is critical to reexamine recommended protective measures for dermatologic surgery. Since COVID-19 is transmitted through droplets and aerosols,2 it is premature to resume elective laser procedures, including ablative CO2 and hair removal. However, deferred non-elective excisions and MMS for skin cancer will need to be performed in the near future. The Centers for Disease Control and Prevention (CDC) recommends N95 respirator use for health care workers participating in aerosol-generating procedures (AGP). Therefore, N95 respirators are essential for dermatologic surgeons and staff operating on mucosal regions and/or generating aerosols with electrocautery. The CDC recommends against extended use or reuse of respirators following AGP. However, given N95 shortages, particularly in outpatient dermatology practices, following this recommendation may be unrealistic, with extended use unavoidable. A surgical mask covering the N95 respirator may be considered to extend longevity. Decontamination of N95s for reuse3 or 3D-printed masks have also been proposed;testing would be required to ensure effective filtration. Many hospitals are adequately supporting redeployed resident and attending dermatologists caring for COVID-19 inpatients. As people are discharged from redeployments and perform increasing numbers of essential outpatient dermatological surgeries, it is incumbent upon hospitals, as well as, state and federal governments to ensure adequate access to PPE for all dermatologists and staff.