ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic has caused a rapid and widespread application of telemedicine services in the outpatient setting. Prior to COVID-19, patient satisfaction was measured with Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & Group Survey (CG-CAHPS) and was then measured with the Press Ganey telemedicine survey. Both surveys ask about a patient's likelihood to recommend a particular medical practice, which is a useful, but imperfect, surrogate for overall satisfaction. The purpose of this analysis was to identify any changes in patient satisfaction scores with the implementation of telemedicine services. A retrospective analysis of our institution's experience during the early months of the COVID-19 pandemic compared to the months immediately prior to the pandemic was conducted. The percent of patients with a "Top box" response to survey questions regarding their likelihood to recommend a medical practice were compared. A total of 14 430 CG-CAHPS results collected in November 2019 through February 2020 were compared to 22 009 telemedicine survey results collected between March and May 2020. In general, most medical specialties incorporated telemedicine but suffered a decrease in their patient's likelihood to recommend a medical practice during the first few months of the pandemic. However, the magnitude of this decrease was variable by medical specialty. Physical medicine and rehabilitation and pain medicine had relatively poor scores prior to the pandemic which did not statistically change. Oncology was the sole medical specialty that continued to have unchanged high patient satisfaction scores. These data provide insights for the refinement of telemedicine.
ABSTRACT
Background: TDR, The Special Programme for Research and Training hosted at the World Health Organization, has long supported Low- and Middle-Income Countries in strengthening research capacity through three training programmes: the Postgraduate Training Scheme (PGTS), the Clinical Research and Development Fellowship (CRDF), and the Structured Operational Research Training InitiaTive (SORT IT). In the advent of the COVID-19 pandemic, we assessed whether those trained through these programmes were involved in the COVID-19 response and if so, in which area(s) of the emergency response they were applying their skills. Methods: From the records for each training programme, we identified the individuals who had completed training during the relevant timespan of each programme: 1999-2018 for the CRDF scheme, 2015-2020 for PGTS, and 2009-2019 for SORT-IT. Between March and April 2020, we sent trainees an online questionnaire by e-mail. Results: Out of 1254 trained, 1143 could be contacted and 699 responded to the survey. Of the latter, 411 were involved with the COVID-19 response, of whom 315 (77%) were applying their acquired skills in 85 countries. With some overlap between programmes, 84% of those trained through CRDF were applying their skills in 27 countries, 91% of those trained through PGTS were applying their skills in 19 countries, and through SORT IT, this was 73% in 62 countries. Skills were being applied in various areas of the emergency response, including: emergency preparedness, situation analysis/surveillance, infection control and clinical management, data generation, mitigating the effect of COVID on the health system, and research. Depending on the type of training programme, 26-74% were involved in implementation, operational or clinical research. Conclusion: Research training programmes build research capacity and equip health workers with transferable core competencies and skillsets prior to epidemics. This becomes invaluable in building health system resilience at a time of pandemics.