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INTRODUCTION AND OBJECTIVE: Telemedicine use rapidly increased during the COVID-19 pandemic. However, the efficacy of telemedicine in the inpatient setting has yet to be addressed. To this end, we measured patient and provider satisfaction with video and faceto- face (FTF) consults for inpatient urology consultations and sought to identify the urologic conditions most suitable for video consults. METHODS: New inpatient urology consults between August 2021-October 2021 were randomized to either video or FTF consult. Patient surveys were administered within 24 hours to assess satisfaction and perceived quality of care during the consult (3-point ordinal Likert scale). Survey results were analyzed using Mann- Whitney U tests. Participating urology attendings completed a survey assessing satisfaction and utility of both consultation mediums (3- point ordinal Likert scale), and suitability of video consults for common urologic consultation conditions (5-point ordinal Likert scale). RESULTS: A total of 48 patients were included;23 (48%) received video consult and 25 (52%) FTF consults. There were no significant differences in age or race between the cohorts. The most common reasons for consultation were acute urinary retention (Video: 5 [22%], FTF: 5 [20%]) and urolithiasis (Video: 5 [25%], FTF: 3 [12%]). Both cohorts agreed that they were overall satisfied with their visit (Video: 22 [95.7%], FTF: 25 [100%];p=0.297), received high-quality care (Video: 22 [95.7%], FTF: 23 [92.0%];p=0.61), and would accept the visit modality again in the future (Video: 21 [91.3%], FTF: 25 [100%];p=0.14). Urologists agreed on the utility of both consultation mediums, including ability to gather complete information (Video: 7 [100%], FTF: 7 [100%]) and manage the patient (Video: 6 [85.7%], FTF: 7 [100%];p=0.71). Physician satisfaction was lower for video consult than FTF (Video: 5 [71.4%], FTF: 7 [100%];p=0.38), and physicians were less likely to agree that video consults were satisfactory compared to FTF visits (4 [57.1%]). The most suitable urologic conditions for video consultation were elevated PSA and urinary retention (4.85±0.38), followed by urinary incontinence and nephrolithiasis (4.71±0.49). The least suitable was scrotal wall swelling (2.71±0.76). CONCLUSIONS: With increasing telemedicine utilization, video consults offer an alternative to FTF rounding that may combat difficulties of urologist shortages. Video consults enable urologists to see a wide variety of inpatient consults without hindering patient satisfaction. However, adoption of this tool will rely on physician preference and competence with video technology.
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INTRODUCTION AND OBJECTIVE: During the COVID-19 pandemic, the use of both video visits (VV) and telephone visits (TV) surged. While insurance coverage for VVs has continued after the pandemic, coverage for TVs remains less certain. We sought to evaluate why patients select TVs over VVs in our academic Urology practice. METHODS: All patients who attempted to schedule telemedicine visits with our practice from 11/2020-5/2021 were first offered a VV. If the patient declined a VV and selected a TV, they were prompted to select a reason from a list. Patient and visit characteristics for both VV and TV cohorts were reviewed and these variables were compared between groups. RESULTS: 1937 patients (1180 male, 757 female) completed telemedicine visits (27% VVs, 73% TVs) between 11/2020 and 5/2021 in our practice. Patients who opted for TVs were more likely to be male (74.6% of males vs 69.9% of females, p=.02), older (84.2% of >65 years old vs 71.5% of 51-65 years old vs 58.2% of 18-50 years old, p=.03), Spanish-speaking (85.9% of Spanish-speakers vs 68.9% of English-speakers, p<.001), and returning for a follow-up visit (79.3% of follow-up patients vs 44.2% of new patients, p<.001). The population did not vary significantly by race/ethnicity or socioeconomic status. Among 1409 TV patients, 1300 (92.3%) provided reasons for preferring TV over VV. The most commonly reported reasons were limited access to smart devices (39.4%) and lack of desire for a VV (47.7%). Less frequently reported responses included language barriers (2.1%), dissatisfaction with a prior telemedicine visit (2.1%), and data/network limitations (1%). CONCLUSIONS: Within our urban, racially diverse patient population, the majority of patients preferred TVs over VVs. Limited access to video-capable smart devices was a prevalent reason. Further analysis should be conducted into understanding the reasons why certain groups of patients are significantly more likely to opt for TVs than others, including males, older patients, Spanish-speakers, and follow-up patients. Additionally, in order to improve access to care in underserved areas, congressional efforts to continue adequate reimbursement for TVs should be encouraged and further research into barriers to patients' acceptance of VVs is needed. (Table Presented).
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Background and aim: A group-based fatigue management programme called FACETS has typically been delivered face-to-face to people living with MS within a neuropsychology service. In response to Covid-19 government guidelines, this service adapted to online delivery of their fatigue management group intervention. This study aims to evaluate two FACETS group interventions which were delivered online consecutively within this service. Methods: Group 1 was delivered face-to-face for the first three sessions before being adapted for virtual delivery for the final three sessions. Group 2 was delivered virtually for all six sessions. Quantitative data was collected from outcome measures collected pre-and post-group. Qualitative feedback was gathered to explore participants’ experience of the group as well as the adapted virtual delivery. A thematic analysis was undertaken to identify key themes. Results: Participants in both groups felt they had more control over managing their fatigue and it was having less of an impact on their quality of life. Five themes were identified from participants’ qualitative feedback (knowledgeable content, awareness and learning, validating experience, accessible amendments, patient choice). Discussion: Feedback was largely positive from both groups following the adaptation to online delivery as it offered a cost-and time-effective solution. Participants reflected on the value of a mixed delivery option for future group interventions to facilitate rapport with other participants and empower self-management of their fatigue. © 2022, British Psychological Society. All rights reserved.
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AIMS: The outbreak of severe acute respiratory syndrome coronavirus 2 (COVID-19) is a global pandemic that has had substantial impact across societies. An attempt to reduce infection and spread of the disease, for most nations, has led to a lockdown period, where people's movement has been restricted resulting in a consequential impact on employment, lifestyle behaviours and wellbeing. As such, this study aimed to explore adults' thoughts and behaviours in response to the outbreak and resulting lockdown measures. METHODS: Using an online survey, 1126 adults responded to invitations to participate in the study. Participants, all aged 18 years or older, were recruited using social media, email distribution lists, website advertisement and word of mouth. Sentiment and personality features extracted from free-text responses using Artificial Intelligence methods were used to cluster participants. RESULTS: Findings demonstrated that there was varied knowledge of the symptoms of COVID-19 and high concern about infection, severe illness and death, spread to others, the impact on the health service and on the economy. Higher concerns about infection, illness and death were reported by people identified at high risk of severe illness from COVID-19. Behavioural clusters, identified using Artificial Intelligence methods, differed significantly in sentiment and personality traits, as well as concerns about COVID-19, actions, lifestyle behaviours and wellbeing during the COVID-19 lockdown. CONCLUSIONS: This time-sensitive study provides important insights into adults' perceptions and behaviours in response to the COVID-19 pandemic and associated lockdown. The use of Artificial Intelligence has identified that there are two behavioural clusters that can predict people's responses during the COVID-19 pandemic, which goes beyond simple demographic groupings. Considering these insights may improve the effectiveness of communication, actions to reduce the direct and indirect impact of the COVID-19 pandemic and to support community recovery.
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COVID-19 , Adult , Artificial Intelligence , COVID-19/epidemiology , Communicable Disease Control , Humans , Pandemics , SARS-CoV-2ABSTRACT
The State of Emergency for the COVID-19 pandemic has created an environment where urologists can continue to safely provide care through telemedicine. We hope this article helps urologists successfully implement telemedicine and video visits. This will maintain safety both for our patients and for the health care workers in our offices. © 2020 Advanstar Communications Inc.. All rights reserved.