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1.
Telehealth and Medicine Today ; 7(2), 2022.
Article in English | ProQuest Central | ID: covidwho-2026491

ABSTRACT

Discussion focus on the top legal and regulatory issues affecting the delivery and reimbursement of telehealth services during the COVID-19 pandemic and how legislatures and government agencies at federal and state levels are responding in the aftermath to implement permanent changes and enforce fraudulent activities. The session provides valuable insights for startups and existing telemedicine practices seeking to understand strategic planning to optimize market success and maintain a compliant multi-state practice.

2.
Telehealth and Medicine Today ; 6(4), 2021.
Article in English | ProQuest Central | ID: covidwho-2026486

ABSTRACT

The COVID-19 pandemic led to temporary relaxations for telehealth with respect to physician licensure, geographic location, and eligible sites for reimbursement. Earlier policies had impacted the rate of adoption of telehealth and retarded the ability to derive full benefits related to cost, access to care, and quality of care. This aspect is analyzed using 2018 Medicare fee-for-service codes and rates for 10 telemedicine services. Based on the analysis of these data, additional research, and literature review, this report describes how interstate practices can be better leveraged to achieve maximum potential for direct and indirect savings that can accrue through such pragmatic approaches for certain services. The interstate collaborations proposed in this report provide examples of broader telehealth policies that could foster increasing access to quality health care for Medicare beneficiaries and can potentially be used as insight to assist federal and state agencies as they review the continuation, cessation, or modifications of relaxations granted due to the COVID-19 pandemic.

3.
Telehealth and Medicine Today ; 6(4), 2021.
Article in English | ProQuest Central | ID: covidwho-2026483

ABSTRACT

As we look towards post-pandemic health delivery, the role of telehealth must be examined. We use the RE-AIM framework to discuss the challenges and successes of telehealth during the pandemic in the United States, and propose critical aspects to consider for optimizing telehealth care in the future.

4.
Telehealth and Medicine Today ; 6(3), 2021.
Article in English | ProQuest Central | ID: covidwho-2026477

ABSTRACT

COVID19’s silver lining in healthcare technology ushered in a massive adoption of virtual care by health systems, clinicians, and patients. In the post pandemic world, as consumer/patient adoption for digital health access exponential continues to grow—Health systems, Insurers, and clinicians all need re-evaluate strategies create larger budgets, and commitments towards Digital health. The growth and rapid adoption seen during the early months of the pandemic was stimulated by removal of legislative, financial and reimbursement barriers. Healthcare systems must carefully and strategically evaluate secure, purpose built, and strategic technological investment.

5.
Telehealth and Medicine Today ; 6(1), 2021.
Article in English | ProQuest Central | ID: covidwho-2026466

ABSTRACT

For long-term and episodic telehealth, we start to see the “final mile experience” with home delivery of pharmaceuticals, durable medical equipment, and even direct-to-consumer lab testing. [...]I am optimistic that synergistic integration of telehealth services with big data, AI-powered algorithms and information from wearables or mobile devices will have the greatest positive impact on healthcare and its outcomes over the next 2–5 years (more than any digital technology alone). [...]rideshare companies bent the cost curve to the point where riders can stop paying high monthly parking fees (aka insurance premiums) and continue to get low-cost, safe, reliable transportation (aka virtual visits) when needed. [...]telehealth will follow the rideshare roadmap…or maybe we will just merge industries.2 Ingrid Vasiliu-Feltes Over the past few years, we have witnessed a significant increase in telehealth adoption and expansion. “Tele-XR-Health” (a telehealth clinic with VR powered medical treatments) has the potential to redefine and reshape medical education, medical training, virtual healthcare delivery, and virtual clinical trials.

6.
Telehealth and Medicine Today ; 6(1), 2021.
Article in English | ProQuest Central | ID: covidwho-2026465

ABSTRACT

The global COVID-19 pandemic demonstrated the vulnerability of healthcare delivery to patients worldwide and challenged healthcare providers—not only in treating patients with coronavirus but also in trying to maintain optimal care for non-COVID patients at the same time. But challenging times often provide a fertile environment for innovation, and we have certainly seen major transformation in health care this year, via technology and global models, with the goal to democratize health care and provide greater access and more efficient and effective delivery of healthcare services to patients, regardless of their income or geography. Some of the world’s top leaders and influencers in healthcare delivery transformation and health technologies, including blockchain and telehealth, converged at the 4th Annual CONV2X 2020 Symposium held virtually from November 10 to 12, to talk about healthcare transformation. By far, one of the most widely discussed topics in the many sessions that took place over the 2-day event was virtual health.

7.
Online Journal of Rural Nursing and Health Care ; 22(1):42, 2022.
Article in English | ProQuest Central | ID: covidwho-2025712

ABSTRACT

Utilization of telehealth services and the provision of chronic care management in school-based clinics have proven to be successful care models in the management of pediatric asthma. Such models of care have also been positively correlated with an improvement in pediatric asthma outcomes. These models of care were historically implemented to improve access to healthcare for patients living in rural populations. During the pandemic, such services were employed to improve access to care to everyone as they practiced social distancing to slow the spread of covid-19. The pandemic levelled the playing field and made access to care a problem for not only rural populations, but a problem for everyone. In order to continue insurer reimbursements for telehealth and school-based healthcare services, research is needed in support of these healthcare models.

8.
Preventing Chronic Disease ; 19, 2022.
Article in English | ProQuest Central | ID: covidwho-2025236

ABSTRACT

Future research using big data from multiple sources (eg, community health needs assessments, surveillance systems, GIS mapping, electronic health records, practice-based research networks) will provide timely, population-based information to evaluate and drive changes to policy and delivery systems and oral health advocacy efforts. The applied research agenda being developed by the American Association of Public Health Dentistry (7) and the “Consensus Statement on Future Directions for the Behavioral and Social Sciences in Oral Health,” which is based on an international summit (8), are helpful in setting research and methodologic priorities, including qualitative, implementation, and health systems research. How does the health of a community’s high caries risk groups change with policies such as a tax on sugar-sweetened beverages, Medicaid reimbursement changes, or health promotion efforts to improve oral health literacy and dietary behaviors? Will the World Health Organization’s addition of dental products (eg, fluoride toothpaste, low-cost silver diamine fluoride, glass ionomer cement) to its Model List of Essential Medicines (9) increase their use to prevent and treat dental caries for under-resourced populations without access to conventional high-cost dental care?

9.
Healthcare ; 10(8):1534, 2022.
Article in English | ProQuest Central | ID: covidwho-2023399

ABSTRACT

Background/rationale: Despite mounting evidence about delirium, this complex geriatric syndrome is still not well managed in clinical contexts. The aging population creates a very demanding area for innovation and technology in healthcare. For instance, an outline of an aging-friendly healthcare environment and clear guidance for technology-supported improvements for people at delirium risk are lacking. Objective: We aimed to foster debate about the importance of technical support in optimizing healthcare professional practice and improving the outcomes for inpatients’ at delirium risk. We focused on critical clinical points in the field of delirium worthy of being addressed by a multidisciplinary approach. Methods: Starting from a consensus workshop sponsored by the Management Perfectioning Course based at the Marco Biagi Foundation (Modena, Italy) about clinical issues related to delirium management still not addressed in our healthcare organizations, we developed a requirements’ analysis among the representatives of different disciplines and tried to formulate how technology could support the summaries of the clinical issues. We analyzed the national and international panorama by a PubMed consultation of articles with the following keywords in advanced research: “delirium”, “delirium management”, “technology in healthcare”, and “elderly population”. Results: Despite international recommendations, delirium remains underdiagnosed, underdetected, underreported, and mismanaged in the acute hospital, increasing healthcare costs, healthcare professionals’ job distress, and poor clinical outcomes. Discussion: Although all healthcare professionals recognize delirium as a severe and potentially preventable source of morbidity and mortality for hospitalized older people, it receives insufficient attention in resource allocation and multidisciplinary research. We synthesized how tech-based tools could offer potential solutions to the critical clinical points in delirium management.

10.
Antibiotics (Basel) ; 11(8)2022 Jul 22.
Article in English | MEDLINE | ID: covidwho-2023068

ABSTRACT

Point-of-care diagnostic tests for community-acquired acute respiratory tract infections (CA-ARTI) can support doctors by improving antibiotic prescribing. However, little is known about health technology assessment (HTA), pricing and funding policies for CA-ARTI diagnostics. Thus, this study investigated these policies for this group of devices applied in the outpatient setting in Europe. Experts from competent authority responded to a questionnaire in Q4/2020. Information is available for 17 countries. Studied countries do not base their pricing and funding decision for CA-ARTI diagnostics on an HTA. While a few countries impose price regulation for some publicly funded medical devices, the prices of CA-ARTI diagnostics are not directly regulated in any of the surveyed countries. Indirect price regulation through public procurement is applied in some countries. Reimbursement lists of medical devices eligible for public funding exist in several European countries, and in some countries these lists include CA-ARTI diagnostics. In a few countries, the public payer funds the health professional for performing the service of conducting the test. Given low levels of regulation and few incentives, the study findings suggest room for strengthening pricing and funding policies of CA-ARTI diagnostics to contribute to increased acceptance and use of these point-of-care tests.

11.
BMJ Open ; 12(9), 2022.
Article in English | ProQuest Central | ID: covidwho-2020060

ABSTRACT

IntroductionIncreases in the use of telehealth in palliative care (telepalliative care) prior to, and during, the COVID-19 pandemic have resulted in a proliferation of studies on the topic. While knowledge is building on how providers and recipients adapt to telepalliative care, no reviews have, as of yet, examined telepalliative care from a patient and family perspective. Therefore, the aim of this integrative review is to explore patients and families’ perspectives on telepalliative.Methods and analysisAn integrative review will be performed inspired by the methodology of Remmington and Toronto from March 2022 to December 2022. Medline, Embase, PsycINFO and CINAHL will be searched for primary peer-reviewed studies that describe telepalliative care from patient and families’ perspectives. Limiters will be used for age;18 years+, time;10 years, and language;English and Danish. Hand searches of authors of included articles and reference lists of included articles will be performed. Two reviewers will independently screen and appraise selected articles using the Mixed Method Appraisal Tool. Conflicts will be resolved through discussions with a third reviewer. Data will be extracted independently by two reviewers into a data matrix with predefined headings and analysed using thematic analysis. Findings will be reported thematically, summarised into a thematic synthesis and discussed in relation to relevant literature.Ethics and disseminationEthical approval is not required for this review. Results will be published in an international peer-reviewed journal and presented at a relevant international conference. Reporting of this protocol was guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocol checklist and prospectively reported to PROSPERO (CRD42022301206).

12.
BJU International ; 130(3):271-272, 2022.
Article in English | Scopus | ID: covidwho-2019159
13.
Chest ; 162(3):505-506, 2022.
Article in English | Scopus | ID: covidwho-2015001
14.
Annals of the Rheumatic Diseases ; 81:443-444, 2022.
Article in English | EMBASE | ID: covidwho-2008889

ABSTRACT

Background: During the COVID-19 pandemic telemedicine tools rapidly and widely gained acceptance as indispensable management tools for the continuum of clinical care in rheumatic diseases. They have been adopted in position papers and guidelines for the management of rheumatic diseases in adult patients. Objectives: Evaluation of the use of video consultation as one form of tele-medicine before and during the COVID-19 pandemic and associated lockdowns among Rheumatology physicians in Germany. The survey results are expected to support the optimization and implementation of video consultation (VC) into routine clinical practice in rheumatology, providing long-term benefts for both parties, patients and their treating rheumatologists. Methods: Cross-sectional nationwide online survey among German rheumatolo-gists and rheumatologists in training. The survey was promoted by newsletters sent by means of mail and Twitter posts to members of the German Society for Rheumatology (n=1,650) and German Professional Society for Rheumatology (n=527). Results: Reported data refer to 205 participants. The majority of respondents was male (59%), older than 40 years (90%) and specialized in internal medicine/rheumatology (85%). They were divided into two groups: 'digital users' (38%) and 'digital non-users' (62%). Users employing telemedicine (TM) but never VC were defned as 'TM-users' (10%). Those using TM and VC were classifed as 'VC-users' (27%). 'Non-users' negated the use of VC and TM respectively. Knowledge on telemedicine was self-rated as 4 (median on a Likert Scale 1 (very high) to 6 (very low)) with a signifcant difference between user (VC-user 2.7±1.2, TM-user 3.2±1.1) and non-user (4.4±1.3). The Figure 1 shows a signifcant increase in the use of VC during the lockdown periods. Even between the lockdown phases, VC use was higher than in the pre-pandemic phase. Reasons for VC non-use in TM-user and non-user were administrative/technical efforts (21%), lack of technical equipment (15%), time constraints (12%), time required for individual VC sessions (12%), inadequate reimbursement (11%), lack of demand from patients (11%), data security concerns (9%), poor internet connection (8%), and lack of Scientific evaluation/evidence (5%). Based on the experience gained, physicians considered the following clinical situations to be particularly suitable for VC: follow-up visits (VC-user 79%, TM-user 62%, non-user 47%), emergency consultations (VC-user 20%, TM-user 33%, non-user 20%), and patients presenting for the frst time (VC-user 11%, TM-user 19%, non-user 8%). Conclusion: Despite the fact that the current pandemic situation, with social distancing and several lockdowns, provides an ideal environment for the implementation of new remote care forms such as VC, their use and acceptance remained below expectations. Given the reported decline in physician face-to-face consultations during the pandemic, these fndings are even more concerning. The identi-fed reasons for non-utilization should be addressed by policy makers, payers and medical societies to provide better foundations for future innovative care models.

15.
Female Pelvic Medicine and Reconstructive Surgery ; 28(6):S152, 2022.
Article in English | EMBASE | ID: covidwho-2008700

ABSTRACT

Introduction: Minimally invasive sacrocolpopexy (SCP) is the gold-standard treatment for patients with apical prolapse and is increasingly used as a primary intervention in women with uterovaginal prolapse. There is a lack of comparative data evaluating costs between SCP versus native tissue vaginal repair in the post-ERAS implementation era. Objective: The primary aim was to determine the cost difference between performing hysterectomy and minimally-invasive sacrocolpopexy as compared to vaginal hysterectomy with native tissue vaginal repair for uterovaginal prolapse. We hypothesized that minimally-invasive sacral colpopexy has a higher cost when compared to native tissue repair but when failure rates of native tissue repair approach 15%, costs equilibrate. Methods: This was a retrospective cohort study at a tertiary care center. The electronic medical record system was queried for women who underwent native tissue vaginal repair or minimally invasive SCP with concomitant hysterectomy for uterovaginal prolapse in calendar year 2021 (post-COVID enhanced recovery after surgery implementation). We excluded all patients who had concomitant colorectal procedures and where billing was not complete or re-imbursement was not received. Hospital charges, direct and indirect costs and operating margin (net revenue minus all costs) were obtained from Strata Jazz and were compared using R statistical program. Net revenue (reimbursement) was directly obtained from the record as the total payment received by the hospital from the payor. Results: A total of 81 women were included, (33 SCP (25 robotic and 8 laparoscopic) versus 48 native tissue). Payor mix included 27% Medicare, 5% medicaid, 61% employer-based and 7% private insurance. Demographic and surgical data is presented in Table 1. The mean total charge per case for services was higher in the SCP group compared to the vaginal repair group ($119,863 vs. $82,205, P < 0.01). Cost of supplies was more in the SCP group ($4429 vs. $2108, P < 0.01), but the cost of operating room time and staff was similar ($7926 vs. $7216, P = 0.06). Controlling for surgeon, age and BMI, the direct and indirect costs were also higher in the SCP group ($13,649 vs. $10,168, P < 0.01 and $5068 vs. $3685, P < 0.01, respectively). Net revenue was lower for the vaginal repair group compared to the SCP group ($14,614 vs. $31,618, P < 0.01). The operating margin was significantly higher in the SCP group ($11,770 vs. $ 517, P < 0.01). Additionally, there were no significant differences in the net revenue between different payors (P = 0.8997). Same-day discharge and EBL were similar among both groups with operative time being higher in the SCP group (204 vs. 161, P < 0.01). Using the means of the direct costs between groups, a re-operation rate of 25.5% would be needed for the native tissue repair costs to equilibrate to the SCP group. From a hospital perspective, due to the low operating margins experienced with native tissue vaginal repair, 227 native tissue vaginal repairs would need to be performed for the same net return as 10 minimally-invasive SCP's. Conclusions: Vaginal hysterectomy with native tissue repair had lower direct and indirect costs compared to minimally-invasive SCP. However, operating margins are significantly higher for SC P due to net revenue received. (Table Presented).

16.
Journal of public health management and practice : JPHMP ; 2022.
Article in English | MEDLINE | ID: covidwho-2008685

ABSTRACT

Telehealth and virtual care quickly became important tools in caring for patients while the COVID-19 pandemic evolved. Telehealth implementation can increase affordability for patients, eliminate access barriers, and improve patient satisfaction. Multiple challenges to successful telehealth implementation have been documented in the literature and are generally categorized as structural barriers of the health system, clinical barriers of the provider, and patient-centered barriers. In this study, we sought to collect themes and observations about this rapid transition to telehealth from practicing primary care clinicians, with the goal of identifying opportunities to improve adoption of telehealth. Themes reported in this article emerged from physician and physician assistant fellows of 2 HRSA-funded grants: (1) Primary Care Training and Enhancement (PCTE) and (2) Primary Care Training and Enhancement Training Primary Care Champions (Champions). The PCTE participants consisted of 8 providers from The MetroHealth System (MHS). The Champions participants consisted of 20 providers from MHS and Federally Qualified Health Centers in Northeast Ohio and Michigan. Participants identified 5 major themes that affected telehealth delivery in an academic medical system: reimbursement and productivity;social determinants of health;privacy and environment of care concerns;teaching;and communication skills. Examples within each theme are provided along with an identified improvement opportunity. As we create solutions to address these challenges, our hope is to pool our experience with others so that we can collectively learn how to best evolve and improve the telehealth experience for all.

17.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2005694

ABSTRACT

Background: Patients with cancer have high rates of healthcare utilization due to complications of disease and treatment. Early identification of patient illness may help reduce acute care use and improve quality of care. Remote patient monitoring (RPM), a type of telemedicine involving collection and transmission of health data from a patient's home to clinicians, has promise to alleviate disparities by providing timely access and early intervention, particularly during the COVID-19 pandemic. Studies of digital interventions in oncology have demonstrated reduction in symptom distress and unplanned hospitalizations but lack focus on minority patients whereas studies of telehealth aiming to address disparities have not focused on patients with cancer. In this pilot study, we aimed to evaluate the feasibility of RPM among patients with cancer at a large urban medical center serving a racially and socioeconomically diverse population. Methods: We partnered with a secure HIPAA-compliant platform and FDA-approved RPM device, Current Health, which monitored heart rate, temperature, respiration, oxygen saturation, and blood pressure. The kit included broadband access and a tablet to provide telehealth services. Oncology Clinicians determined clinical inclusion and exclusion criteria of RPM initiation for patients on the bone marrow transplant service and patients with myeloma and lung cancer. A centralized team of Nurse Practitioners (NPs) monitored alarms. Clinical alarms indicated abnormal vital signs;technical alarms indicated no data transmission for a 12-hour period. We measured feasibility by recruitment and retention, and used descriptive statistics to describe the study population, time enrolled on RPM, and alarms. Results: To date, we enrolled 30 patients on the RPM platform over a 10-month period with a weekly census of 9-10 patients undergoing RPM monitoring. Of the 30 patients, 17 (57%) were white, 7 (23%) Black, and 2 (7%) Asian;2 patients (7%) identified as Hispanic. The average age was 57.4 years. The majority of patients (93%) had hematologic malignancies, all of whom were enrolled on hospital discharge. Of the 2 patients with lung cancer, 1 patient was enrolled from the outpatient setting and 1 following hospital discharge. The mean length of time per patient enrolled with the device was 21.7 days. Over 10 months, there were 393 technical and 62 clinical alarms with an average of 3 clinical alarms per week addressed by NPs by phone, indicating low clinician burden. Conclusions: This pilot study demonstrated the feasibility of RPM monitoring in patients with cancer. Future studies should evaluate patient-reported and healthcare utilization outcomes, as well as barriers to reimbursement. The identification of best practices in telemedicine implementation can accelerate adoption and increase high quality, timely, and equitable cancer care.

18.
Journal of Clinical Oncology ; 40(16), 2022.
Article in English | EMBASE | ID: covidwho-2005677

ABSTRACT

Background: Adequate reimbursement is considered a prerequisite for adoption of new diagnostic technologies that facilitate patient access to better treatments. Detailed longitudinal investigation of the adoption of new HCPCS codes and the factors influencing it are scarce, although the availability of large-scale claims databases should facilitate such studies. We examined claims for three CPT codes used for next generation sequencing (NGS): 81445, 81450 and 81455 in a large database of claims data from CMS and attempted to correlate presumptive drivers of test adoption such as coverage decisions and payments with test volume. Methods: CMS claims data were accessed using CMS' Virtual Research Data Center (VRDC) under data use agreement 50486. Any claim with a CPT code of 81445, 81450 or 81455 was extracted from the data and analysed using SAS Enterprise Guide with results summarised in Microsoft Excel. Data relating to national/local coverage determinations were located by internet searches. Results: Test volumes for all 3 codes showed significant variability, including a large decrease around Q1-2 of 2020, likely due to the COVID-19 pandemic. Utilization of the 3 CPT codes varied by patient diagnosis. Details of the top 5 diagnoses for each CPT are given in the Table. The top 30 diagnoses for each CPT code accounted for 80.33%-88.45% of patients. Conclusions: Utilisation of NGS testing from 2016-2021 was highly variable, confounding attempts to match potential drivers to changes in monthly test volumes. A relatively small number of conditions accounted for >80% test use. Increased use of 81445 and 81450 from 2019 onwards may be related to CMS LCD issued in March 2018, suggesting that it can take 8-9 months or more for a LCD to filter through to testing practice. Decreases in test volume around March 2020 coincide with decreased patient presentation and testing for cancer because of the COVID-19 pandemic indicating that factors beyond reimbursement can significantly affect test use. Changes in reimbursement or adoption of proprietary lab analysis (PLA) codes covering specific NGS tests may have caused the drop in test volumes in the latter half of 2021. This study demonstrates that determination of factors affecting adoption of a test technology can be problematic due to wide variation in claims over a relatively short space of time. However, determination of these factors is important as they ultimately affect patient access to testing and potentially to therapy. (Table Presented).

19.
Pediatrics ; 149, 2022.
Article in English | EMBASE | ID: covidwho-2003070

ABSTRACT

Background: Connecting the mouth to the rest of the body is critical for providing whole-person, patient-centered, comprehensive healthcare. The COVID-19 crisis has provided an opportunity for elevation and expansion of oral health prevention education into telemedicine, particularly using video connections. Access to dental care substantially decreased during this time. Public acceptance and demand have increased simultaneously. Most oral health conditions are preventable (-30-85%) with improvement of personal habits and quality dental care. Integration of prevention-centric approaches to oral health care into telemedicine can overcome barriers and have a favorable impact on oral and overall health of all populations. Using a DEI lens, we propose to create a compendium of effective best practices/innovations for oral health integration in telemedicine (OHFT) that can be adopted widely at minimal cost to support the value of oral health to overall health throughout pediatric healthcare. Methods: To create comprehensive guidance around best practices/innovations incorporating oral health into telemedicine visits, we will conduct expansive focus groups (30+) to research and pilot an assortment of modalities and messages for OHFT in the next 12 months. HTHC at PAAAP will continue working towards collective impact with Primary Care Collaborative, the Oral Health Section of the American Academy of Pediatrics (AAP) and OPEN in subsequent years to 1) monitor pilots/innovations, 2) initiate establishing a CPT procedure code with RVUs, 3) seek USPSTF recommendation of “A” or “B”, and 4) work with AAP Bright Futures Guideline for inclusion of the procedure. We will seek and spread via publication and conference presentations best practices/innovations providing an assortment of modalities and messages for inclusion across the spectrum of telemedicine visits, beginning with pediatric telemedicine visits. Results: Implementation of OHFT will insure reaching all in need. Sustainability would be provided by assuring reimbursement for clinician time spent on implementing OHFT. We postulate a dramatic increase in population oral health and OH literacy from implementation of OHFT. Conclusion: In summary: • OHFT serves families without transportation, CSHCN who are difficult to transport, etc. Many occupy homes impacted by discriminatory practices and poverty. • Smartphone pictures of teeth, mouth, toothbrush, and toothpaste, emailed in advance of the visit ,can be used to aid in addressing the specific needs of the child via video telemedicine - all in about 2 minutes. • Best patient/family centered OHFT practices will be updated frequently for needs of specific communities - CSHCN, limited resources, persons of color, etc. • A CPT Code with RVUs for payment for the services as a procedure, will build profit center capacity increasing oral health literacy of the community along with adoption of good prevention practices. • Medical telehealth visits are demanded by the public. Best practices/innovations must be evaluated through lenses of quality as well as DEI.

20.
Journal of Clinical Lipidology ; 16(3):e36, 2022.
Article in English | EMBASE | ID: covidwho-1996300

ABSTRACT

Lead Author's Financial Disclosures: Nothing to disclose. Study Funding: None. Background/Synopsis: Telehealth services have been implemented in many chronic conditions with the expectation to improve care for patients and has expanded greatly due to the COVID pandemic. Little is known about the impact that telehealth on the practice of lipidology. Objective/Purpose: To determine the current utilization of telehealth for lipid management and explore barriers and enablers to telehealth's future impact on the practice of lipidology. Methods: The PubMed database was searched from inception to June 25, 2021, to identify all relevant articles published utilizing telehealth for lipid management. This search returned 376 articles when using the following key words: "lipids or cholesterol" and "telehealth". Articles were included at screening if they mentioned telehealth and lipids. The definition of telehealth was refined during full-text screening as a synchronous visit between a patient and a clinician that replaced an in-office appointment. All other types of telehealth were excluded including those that only implemented mobile health technologies, remote monitoring, or call backs for return of laboratory results. Additionally, articles had to measure lipid levels. Article findings were synthesized into one of the following categories: 1) barriers to implementing and delivery of telemedicine visits, 2) facilitators to implementing and delivery of telemedicine visits, 3) clinician perspectives on telemedicine, or 4) mention future utility of telemedicine. Results: Of the 376 articles found, 128 s were included, and 79 articles were included after full text screening. The main reason for exclusion were not meeting the definition for telemedicine. Of the 81 articles, 18 were reviews, 31 were randomized clinical trials, 15 were pre-post evaluations, and 15 were categorized as other study designs. About half of the articles reported telehealth services for individuals with diabetes. Barriers reported include lack of evidence that supports telemedicine's impact or sustainability, technology cost, high appointment cancelation rates, and lack of reimbursement for clinicians. Enablers reported positive to no-negative impact on health outcomes, cost savings for health systems, and easier implementation of multidisciplinary approaches to care. Clinicians had mixed feelings on their ability to deliver clinical care, but report improved patient satisfaction. Future use of telemedicine included mentions of the need for new reimbursement structures, technology literacy programs, and revisions to current clinician licensing laws. Conclusions: Telemedicine use to provide care for individuals with lipid conditions has expanded during the COVID pandemic, but more research is needed to determine whether it is a sustainable model for lipid management.

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