The impact of COVID-19 lockdown on the health and care of children and adolescents with a childhood-onset disability

Introduction: During the initial period of COVID-19 lockdown, restriction measures modified the day-to-day life of the population. This study sought to know the impact of this period on the physical and mental health of children and young people with disabilities originating in childhood, and their families, and to describe the changes that occurred in access to education and health services. Material and methods: An observational and cross-sectional analytical study was carried out. The data were obtained by means of an electronic survey through an online platform carried out by the European Academy of Childhood Disability. The survey included questions on four thematic blocks: sociodemographic and health characteristics, impact of lock down on health and well-being, and access to education and health services. Results: One hundred and forty-five responses were obtained. 45.5% of the children and young people were totally dependent. There was an impact on their physical (54.5%), mental health (47.6%) and both (32%), higher levels of stress (68.3%), and sleep problems (41.4%), as well as a high burden in 84.8% of parents, especially in families of children with a higher level of dependency (P =.00). 55% of children and young people did not receive any treatment during this period, not even remotely. Conclusions: COVID lock down period greatly affected physical and mental health, as well as the services for children and young people with disabilities and their families. © 2022 The Author(s)

Time Spent in the Electronic Health Record by Neurologists: Analyzing daily use inside and outside the clinic using EPIC Signal data

Objective: To quantify how long neurologists spend in the electronic health record (EHR). Background: Neurologists have extensive information needs for decision-making (e.g., neuroimaging, video-recordings) that are likely to affect time spent in the EHR. While EHRrelated burden is being increasingly studied due to the national spotlight on physician burnout, few studies have focused on neurology. Design/Methods: Data were obtained using Epic Signal, which provides detailed data on how long clinicians spent on different EHR interfaces. We focused on all neurologists from an academic health system in Florida who practiced during November 2019 to October 2020 inclusive. Our EHR outcome measures were time spent interacting with the EHR, time spent in the EHR outside scheduled clinic hours, inbox management, writing notes, and chart review. We reported the median and range of outcome measures because they had skewed distributions. We also assessed whether changes related to the coronavirus pandemic (e.g., telemedicine adoption) were associated with differences in EHR use via Wilcoxon signed-rank tests. Results: Our sample contained 2,286 physician-week observations (83 neurologists). They spent up to: 333.6 minutes/day (median:66.5, range:0.5-333.6) interacting with the EHR, 303.4 minutes/day (median:27.8, range:0.0-303.4) in the EHR outside scheduled hours, 45.6 minutes/day (median:3.4, range:0.0-45.6) in the In Basket, 240.3 minutes/day (median:31.1, range:0.0-240.3) writing notes, and 73.1 minutes/day (median:11.0, range:0.0-73.1) in clinical review. EHR measures were comparable before and during the pandemic. Conclusions: Similar to physicians in other specialties, neurologists spend a significant proportion of their clinical effort engaged with the EHR. Neurologists may benefit from interventions that reduce time spent in the EHR, such as after-hours EHR use and documentation.