Benefits and challenges of using virtual primary care during the COVID-19 pandemic: From key lessons to a framework for implementation

Background: With the onset of COVID-19, general practitioners (GPs) and patients worldwide swiftly transitioned from face-to-face to digital remote consultations. There is a need to evaluate how this global shift has impacted patient care, healthcare providers, patient and carer experience, and health systems. Research question: We explored GPs' perspectives on digital remote care's main benefits and challenges. Method(s): GPs across 20 countries completed an online questionnaire between June and September 2020. GPs' perceptions of main barriers and challenges were explored using free-text questions. Thematic analysis was used to analyse the data. Result(s): In our survey 1605 respondents participated. The benefits identified included reducing COVID-19 transmission risks, guaranteeing access and continuity of care, improved efficiency, faster access to care, improved convenience and communication with patients, greater work flexibility for providers, and hastening the digital transformation of primary care and the accompanying legal frameworks. Main challenges included patient's preference for face-to-face consultations, digital exclusion, lack of physical examinations, clinical uncertainty, delays in diagnosis and treatment, overuse and misuse of digital remote care, and unsuitability for certain types of consultations. Other challenges include the lack of formal guidance, higher workloads, remuneration issues, organisational culture, technical difficulties, implementation and financial issues and regulatory weaknesses. Conclusion(s): At the frontline of care delivery, GPs can provide important insights on what worked well, why, and how. Lessons learned during the emergency phase can inform the stable adoption of virtual care solutions and co-design processes and platforms that are technologically robust, secure, and supported by a long-term strategic plan.

In-the-Moment Experiences of Rural School Principals in the COVID-19 Pandemic

The COVID-19 pandemic has exposed the many existing inequalities in education systems across the world. Not all children have easy access to educational online resources or digital technologies, a situation more amplified in rural contexts where access, connectivity and affordability play a significant factor. This qualitative account reveals examples of how rural school leaders were able to find innovative ways early in the COVID-19 pandemic to address the remote learning needs of their students and families. This paper shares in-the-moment experiences of rural principals, and those who supported them, in quickly transitioning to address student needs when school buildings closed. Support actions of regional and state education agencies are also described. Principals’ schools are located in rural areas of Kansas, Pennsylvania and Queensland, Australia. Principals’ attention to place and teacher capacity enabled students and families to access educational offerings and supports in new ways. © 2022. This work is licensed under a CC BY 4.0 license.

Use of Adhesive Tape to Facilitate Optimal Mask Positioning and Use in the Emergency Department: A Randomized Controlled Trial

Study Objective: We hypothesize that placing a piece of surgical tape at the bridge of the nose over the mask, creating a physical deterrent to mask removal, will improve proper mask use among emergency department (ED) patients. Methods: 123 patients were enrolled in a randomized controlled trial at Eskenazi Hospital from April 2020 until October 2020. We permitted participants to either use their own mask (due to low resources institutionally) or we provided a surgical/cloth mask (early on relied on donated cloth masks for patients). Participants were randomized to a control (no tape over the mask/nose) or to the intervention (placing tape over the bridge of the nose of the face mask). The primary outcome of this study is the frequency at which participants correctly wear their masks in the intervention and control groups at 60 minutes into their ED visit. Results: At 60- minutes in the no-tape control group, 31.1% participants were incorrectly wearing the masks, compared to 100% of the intervention group correctly wearing their masks. Subjects who were observed wearing their masks incorrectly (91.1%) exhibited some combination of either their mask removed or their nose and/or mouth exposed. Conclusions: Applying a piece of tape to the bridge of the nose affords a simple, low-cost, low-risk solution that improved the rate of proper mask usage to 100%.