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2.
Ir J Med Sci ; 2022 Mar 17.
Article in English | MEDLINE | ID: covidwho-1750835

ABSTRACT

AIM: To assess progress and outcome of the Virtual clinics during the Covid-19 Pandemic. METHODS: We used Excel sheet to collect and anlyse data including number of call attempts for answer, duration of the calls, success in talking to the carers and the outcome of consulttion. RESULTS: One-hundred-sixty-seven calls were made for 117 patients. Average of 1.3 calls per patient. 94/115 (81.7%) calls were eventually answered. 65% (71) parents answered the call from a single attempt (71/110). 18% (21/110) of parents answered the call on the second attempt. The average call duration was 9 min (range 21-5 min). We discharged 11% (11/103) of patients, while 33% (34/103) patients required a face-to-face physical review. A follow-up appointment was scheduled for 54% patients (58/103). DISCUSSION/CONCLUSION: With careful patients' selection, virtual outpatient clinics represent a feasible means of delivering outpatient care from a clinician perspective.

3.
Ann Otol Rhinol Laryngol ; : 34894221082739, 2022 Mar 02.
Article in English | MEDLINE | ID: covidwho-1724116

ABSTRACT

OBJECTIVE: To determine provider and patient attitudes toward telemedicine in Otolaryngology-Head and Neck Surgery (OHNS). METHODS: Otolaryngology practitioners conducting outpatient clinics at an academic tertiary referral center were provided with a pre-Study Provider Perception Questionnaire (pre-PPQ) designed to evaluate pre-study perception of telemedicine in otolaryngology. A post-study Provider Perception Questionnaire (post-PPQ) designed to evaluate elements similar to those constituting the PrePPQ was completed at 6 weeks. Additionally, following each visit, providers and patients completed Individual Encounter Survey Questionnaires (IESQ) to evaluate the virtual clinical encounter experience. RESULTS: The pre-PPQ was completed by 29 providers, while the post-PPQ was completed by 12 providers. A total of 236 post-visit provider IESQs were completed, of which 208 were deemed successful. Audio/visual (AV) difficulties and limited server connectivity for the patient were most common causes for unsuccessful encounters. Providers reported that the most appropriate use of telemedicine, on both pre-PPQ and post-PPQ, was triaging patients to determine the need for in-person visits. The inability to perform a physical exam was rated as the primary barrier to telemedicine in OHNS on both pre-PPQ and post-PPQ. Patients strongly agreed with the statements, "My healthcare provider was able to understand my healthcare condition" and, "I felt comfortable communicating with my healthcare provider" 92.0% and 95.4% of the time, respectively. CONCLUSION: Both providers and patients demonstrated an overall positive attitude toward the use of telemedicine in the provision of otolaryngologic care.

4.
Healthcare (Basel) ; 9(12)2021 Dec 16.
Article in English | MEDLINE | ID: covidwho-1613726

ABSTRACT

Successful implementation of virtual healthcare depends immensely on patients' perceptions and satisfaction. This cross-sectional study assessed patients' perceptions of, and factors associated with, poor and average satisfaction with the outpatient telemedicine clinics in the Kingdom of Saudi Arabia (KSA). This questionnaire-based survey was conducted among 720 patients who attended outpatient telemedicine clinics from different regions of the KSA. Of the sample studied, 54.7% of the participants had high satisfaction and the most common disadvantage perceived by patients was technical issues (53.1%), followed by fewer personal interactions (30.4%). Around 75% of the participants desired to use telemedicine services even after the COVID-19 pandemic. Logistic regression analysis revealed that age group more than 40 years (OR = 1.59; 95% CI = 1.04-2.44, p = 0.031), education less than university level (OR = 1.68; 95% CI = 1.07-2.15, p = 0.025), and first-time participants (OR = 3.28; 95% CI = 2.32-4.65, p < 0.001) were significantly associated with poor and average satisfaction ratings. The concerned authorities must make targeted action plans to circumvent the disadvantages perceived by patients accessing telemedicine. Furthermore, a multicenter, exploratory study that compares the virtual clinic with other telemedicine services in the KSA is warranted.

5.
J Adv Nurs ; 78(2): 498-509, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1443289

ABSTRACT

AIMS: The overall aim of this evaluation was to look at the impact of the changes in working practices during the pandemic on nurses. This secondary analysis provided an evaluation of virtual care and being able/required to work from home. DESIGN: This was secondary analysis of an evaluation using semi-structured interviews. METHODS: Conducted at a single National Health Service (NHS) university hospital in the United Kingdom between May and July 2020. Forty-eight operational leads and nurses participated in semi-structured interviews which were digitally recorded, transcribed verbatim and analysed using a framework analysis. RESULTS: Two overarching themes emerged relating to the patient experience and nursing experience. There were both positive and negative elements associated with virtual care and remote working related to these themes. However, the majority of nurses found that virtual clinics were useful when proper resources were provided, and managerial strategies were put in place to support them. Participants felt that virtual care could benefit many but not all patient groups moving forward, and that flexibility around working from home would be desirable in the future. CONCLUSION: Virtual care and remote working were implemented to accommodate the restrictions imposed because of the pandemic. The benefits of these changes to nurses and patients support these being business as usual. However, clear policies are needed to ensure that nurses feel supported when working remotely and there are robust assessments in place to ensure virtual care is provided to patients who have access to the necessary technology. IMPACT: This was a study of the move to virtual care and remote working during the COVID-19 pandemic. Telemedicine and flexible working were not common in the NHS prior to the pandemic but the current evaluation supports the role out of these as standard care with policies in place to ensure that nurses and patients are appropriately supported.


Subject(s)
COVID-19 , Telemedicine , Humans , Pandemics , SARS-CoV-2 , State Medicine
6.
Cureus ; 13(8): e16974, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1369914

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic has resulted in nationwide stay-at-home orders in an effort to slow the spread severely impacting the healthcare sector. Telepsychiatry provides a platform bridging the gap through advanced technologies connecting mental health providers and patients who need their services, overcoming previous barriers of great distances, lack of transportation, and even time constraints. The most obvious benefit is increased accessibility to mental healthcare, especially in underserved and remote areas where there is no easy access for in-person care. It is important to note that benefits are not limited to patients, but also allow clinicians greater flexibility in scheduling and reduced practice overhead costs, both of which aid with physician burnout and burden. Telepsychiatry during COVID-19 provides its own unique advantages over in-person visits. The risk of exposure to healthcare workers and patients receiving care is reduced, allowing immunocompromised patients to receive much-needed psychiatric care. Without the need to meet in person, self-isolating psychiatrists can still provide care, decreasing strain on their co-workers. Although telepsychiatry is relatively new, it has already exhibited considerable success in its effectiveness at treating psychiatric conditions and widespread corollary benefits. Telepsychiatric consults may be carried out synchronously and asynchronously, each having benefits and setbacks. Different mobile application interventions have been explored, which are available for the purpose of both monitoring/assessing patients and/or providing treatment. The scope of conditions these applications address is broad, from anxiety disorders to schizophrenia to depression. As promising and beneficial telepsychiatry may seem, it is necessary to recognize that building the program can be challenging. It involves adapting to new methods in medicine. We highlighted barriers to general telepsychiatry, the most prominent being technological literacy of both physician and patient, and possible negative effects of eliminating the in-person patient-doctor interaction.

7.
Cureus ; 13(7): e16107, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1337815

ABSTRACT

Introduction The novel coronavirus, officially known as COVID-19, was first reported in Wuhan, China, in December of 2019. Since that time, medical services in Saudi Arabia have adapted to the situation by delivering medical care via virtual clinics. Therefore, the aim of the study is to assess physicians' perception and the level of satisfaction with telemedicine during the COVID-19 pandemic in Riyadh, Saudi Arabia. Methods This was a cross-sectional study that included family medicine consultants and fellows who had used telemedicine in primary health care centers in Riyadh, Saudi Arabia. It was conducted using an online validated questionnaire. The questionnaire was completed by 219 family medicine consultants and fellows, after obtaining their informed consent. The data that were extracted from the questionnaire included demographics, level of satisfaction, and questions related to their experience with telemedicine. Results Two hundred and nineteen participants enrolled in this study with 50.6% males and 49.4% females. The overall level of physicians' satisfaction with telemedicine was 64.3%. However, only one-third preferred telemedicine over office visits. Of these, 60% were males and 40% were females. The only factor that had a statistically significant effect on the preference of office visits or telemedicine was time efficiency (p-value < 0.001). Of those who preferred office visits over telemedicine, 52% of them cited ease of discussion and the ability to make a comprehensive physical examination as the most important reasons for choosing office visits. Technologic issues were the least important factor for choosing either clinic (4.1%). Of those who preferred telemedicine, avoiding contact with patients suspected of COVID-19 was the most commonly cited factor (27.4%). Family medicine physicians face multiple barriers while using telemedicine during the COVID-19 pandemic. The most commonly cited barrier was the inability to make a full and comprehensive assessment of the patient. Conclusions In the setting of highly transmissible disease epidemics, telemedicine has a lot of potential for providing quick and safe care that is appropriate for screening and management. Based on our findings, using telemedicine should be encouraged by improving physicians' skills in this field since telemedicine is a crucial step to reduce the risk of COVID-19 transmission and provide community-wide treatment.

8.
Cureus ; 13(7): e16392, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1332368

ABSTRACT

The current COVID-19 pandemic has boosted a sudden demand for telemedicine due to quarantine and travel restrictions. The exponential increase in the use of telemedicine is expected to affect ophthalmology drastically. The aim of this review is to discuss the utility, effectiveness and challenges of teleophthalmological new tools for eyecare delivery as well as its implementation and possible facilitation with artificial intelligence. We used the terms: "teleophthalmology," "telemedicine and COVID-19," "retinal diseases and telemedicine," "virtual ophthalmology," "cost effectiveness of teleophthalmology," "pediatric teleophthalmology," "Artificial intelligence and ophthalmology," "Glaucoma and teleophthalmology" and "teleophthalmology limitations" in the database of PubMed and selected the articles being published in the course of 2015-2020. After the initial search, 321 articles returned as relevant. A meticulous screening followed and eventually 103 published manuscripts were included and used as our references. Emerging in the market, teleophthalmology is showing great potential for the future of ophthalmological care, benefiting both patients and ophthalmologists in times of pandemics. The spectrum of eye diseases that could benefit from teleophthalmology is wide, including mostly retinal diseases such as diabetic retinopathy, retinopathy of prematurity, age-related macular degeneration but also glaucoma and anterior segment conditions. Simultaneously, artificial intelligence provides ways of implementing teleophthalmology easier and with better outcomes, contributing as significant changing factors for ophthalmology practice after the COVID-19 pandemic.

9.
Br J Nurs ; 30(14): 840-844, 2021 Jul 22.
Article in English | MEDLINE | ID: covidwho-1319860

ABSTRACT

BACKGROUND: Inflammatory bowel disease (IBD) is a chronic relapsing and remitting condition. The COVID-19 pandemic has severely disrupted provision of medical care across the world. IBD clinical nurse specialists (CNSs) played a pivotal role in the care of children with IBD during the pandemic national lockdown and in the recovery phase. This article aims to look at the impact of COVID-19 on the paediatric IBD service in one children's hospital and the effect on the IBD CNSs' workload. METHOD: A retrospective review of clinical notes and the service's IBD database from January 2019 to September 2020. RESULTS: There was a significant increase in the number of email and telephone contacts to the IBD CNS team during lockdown. There was an increase in virtual clinics, and an increase in new IBD patients coming to the service, but a reduction in the number of face-to-face consultant clinics. CONCLUSION: COVID-19 has disrupted medical services to children with IBD and led to a reduction in face-to-face activities but has also led to a significant increase in virtual activities. CNSs have taken up a wider role to cover patient care during a time of both medical and nursing redeployment.


Subject(s)
COVID-19 , Inflammatory Bowel Diseases , Nurse Clinicians , Nurse's Role , Child , Hospitals, Pediatric , Humans , Inflammatory Bowel Diseases/nursing , Retrospective Studies , United Kingdom/epidemiology , Workload/statistics & numerical data
10.
Cureus ; 13(6): e16016, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1314946

ABSTRACT

Background The consequences of the coronavirus 2019 (COVID-19) pandemic on healthcare systems worldwide are undeniably disrupting regularly provided care for non-COVID-19 patients. Since the start of the pandemic, medical services in Saudi Arabia have adapted to the situation by providing medical care through virtual clinics. This article aims to evaluate patient satisfaction with virtual clinics during the COVID-19 pandemic. Material and methods A cross-sectional study was conducted among patients who had experience with the virtual clinics of Unaizah College of Medicine, Qassim University, Saudi Arabia. An online questionnaire was sent to all participants who visited the virtual clinic between May 2020 and July 2020. The questionnaire included demographic data and 16 statements to assess patient satisfaction with the virtual clinic experience.  Results A total of 123 participants completed the questionnaire. Their mean age was 33 ± 12 years; 61% were females and 39% were males. Most of the participants were from the Qassim region (77.2%), while 22.8% were from other regions in Saudi Arabia. Dermatology clinics were the most frequently visited virtual clinics, followed by psychiatry clinics. Most of the participants were satisfied with the virtual clinics, with average scores greater than three for most of the components of the questionnaire. Conclusions The participants showed considerable satisfaction for virtual clinics in the time of the COVID-19 pandemic, even though the service was relatively new to them. Future additional efforts will be needed to support clinically appropriate and acceptable virtual visits combined with in-person visits after the pandemic.

11.
J Patient Exp ; 8: 23743735211008284, 2021.
Article in English | MEDLINE | ID: covidwho-1238693

ABSTRACT

The pandemic has resulted in many changes to health services, one of these is the shift from face-to-face consultations to virtual ones across all specialities. As the pandemic continues with no end in sight it seems that virtual consultations will continue for the foreseeable future. In this article, we analyze the patient feedback so far to virtual consultations in a large tertiary center and use this opportunity to reflect on this new service. We have a particular interest in musculoskeletal services as this is largely an outpatient-based speciality and the pandemic has consequently resulted in significant changes in practice. We also consider whether virtual clinics is a sustainable service post-COVID-19 and the benefits and disadvantages of this.

12.
Future Healthc J ; 8(1): e27-e31, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-1168112

ABSTRACT

The COVID-19 pandemic has led to a crisis in the provision of usual services, including face-to-face (FTF) outpatient clinics. The need for change came abruptly in late March 2020 as routine clinics were cancelled. We accelerated the delivery of our teleclinics (telephone and video) in rheumatology, which we had started doing prior to the pandemic. 396 patients were reviewed during the lockdown by teleclinics. 39 (10%) of patients were discharged, 102 (26%) had treatment adjusted without bringing forward their appointment, 39 (10%) had tests ordered and prescriptions issued, 160 (40%) were reviewed and booked for a future appointment, thus reducing the current waiting list, and 22 (6%) were placed a patient-initiated follow-up plan. Only 10 (3%) required a conversion from the teleclinic to a FTF clinic in the near future. The COVID-19 crisis offered us the opportunity to do things we had been considering for some time. Our aim is now to continue with this new way of working as we move to the recovery phase and beyond. We would suggest that adoption of these changes in other trusts could significantly improve the quality of the care for patients not only in rheumatology but also throughout the NHS.

13.
Surgeon ; 19(6): e325-e330, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1117693

ABSTRACT

BACKGROUND: Trauma places a burden on healthcare services accounting for a large proportion of Emergency Department presentations. COVID-19 spread rapidly affecting over 30 million worldwide. To manage trauma presentations the Department of Trauma & Orthopaedic Surgery reorganised service delivery. AIM: To assess the impact of service reorganisation and Virtual Clinics on patients in a Regional Unit in Ireland. METHODS: A retrospective review of trauma activity following introduction of Virtual Fracture Clinics and Theatre COVID Pathways for a 10 week period in comparison with the same 2019 period. All patients underwent both nasopharyngeal and oropharyngeal swabs PCR testing prior to operations. Theatre and outpatient activity were evaluated. Clinic data were accumulated using the Integrated Patient Management System. RESULTS: Theatre Activity: 242 patients underwent surgery in our trauma unit (mean 2.98 per list) during the COVID- 19 period. 29 cases were performed in repurposed elective hospital giving a total of 271 during the 2020 study period. 371 cases were performed in the same 2019 period (mean 4.58 per list). Outpatient Activity: We noted a 25.86% fracture clinic referral reduction during the COVID 19 period compared to 2019. There was a 150.77% increase in patients managed through Trauma Assessment Clinic. 639 patients were managed through the Virtual Fracture Clinic Pathway during COVID 19 period. CONCLUSIONS: Over one in four fracture clinic patients can be managed virtually. A new dedicated Acute Fracture Unit within our institution permitted streamlining of care and social distancing. The "Non-COVID" pathway for ambulatory trauma was essential in managing the growing presentations of these injuries.


Subject(s)
COVID-19 , Trauma Centers , Communicable Disease Control , Humans , Retrospective Studies , SARS-CoV-2
14.
Paediatr Child Health (Oxford) ; 31(5): 220-222, 2021 May.
Article in English | MEDLINE | ID: covidwho-1093187

ABSTRACT

COVID-19 brought a lot of children's routine clinical services in the UK to a complete halt in March 2020. The NHS had to radically change the way clinical services are provided with the rapid introduction of telemedicine, virtual consultations, and video conferencing facilities to support team working. This paper describes how Peterborough Child Development Centre rapidly redesigned the services with digital tools to continue offering neurodevelopmental and neurodisability services more virtually. We demonstrate how we adapted our approaches to assess and manage complex long-term conditions with improved quality and outcomes by using digital tools. The changes to the clinical processes and systems are here to stay beyond the COVID-19 pandemic and have the potential to revolutionise the services.

15.
Ir J Med Sci ; 190(4): 1295-1301, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1064602

ABSTRACT

BACKGROUND: The COVID-19 pandemic has resulted in radical changes in the delivery of healthcare worldwide. Our oncology service (at an Irish national cancer centre) rapidly transitioned to the use of telemedicine or virtual clinics (VC) to minimise potential risk of exposure to COVID-19 amongst an immunosuppressed, high-risk population. Our study aimed to evaluate the use of VC in this setting. METHODS: An 18-point questionnaire was designed to investigate the patient experience of VC during the COVID-19 pandemic in Ireland and compliance with guidelines developed in Ireland to conduct VC and the role of VC in the future. Questionnaires were distributed following the receipt of verbal consent from patients during the VC. Descriptive statistics were utilised for data analysis using SPSS®. RESULTS: One hundred and four patients returned completed surveys (n = 104/164, 63% response rate). Overall satisfaction levels were high with most patients (n = 58/100, 58%; no answer provided (NAP), n = 4) equally satisfied or nearly equally satisfied with VC in comparison to a usual clinic encounter. The majority of patients felt that there should be a role for VC in the future (n = 84/102, 82%; NAP, n = 2). The majority of patients (n = 61/99, 61%; NAP, n = 5) were very relieved to avoid a hospital visit due to perceived risk of potential exposure to COVID-19. CONCLUSION: The majority of oncology patients were satisfied with a VC encounter. VC may have a role in the future of medical care in Ireland post the COVID-19 pandemic.


Subject(s)
COVID-19 , Telemedicine , Ambulatory Care Facilities , Humans , Pandemics , SARS-CoV-2
16.
J Family Community Med ; 28(1): 48-54, 2021.
Article in English | MEDLINE | ID: covidwho-1032631

ABSTRACT

BACKGROUND: The novel coronavirus, officially known as COVID-19, was first reported in Wuhan, China in December of 2019. Since that time, medical services in Saudi Arabia have adapted to the situation by delivering medical care via virtual clinics. Therefore, the present study aimed to assess patients' level of satisfaction with virtual clinics during the COVID-19 pandemic in Saudi Arabia. MATERIALS AND METHODS: This cross-sectional study was conducted among patients who had experienced virtual clinics in primary healthcare centers in Riyadh, Saudi Arabia. An online validated questionnaire was sent to all participants who had at least one virtual visit between March 2020 to July 2020. The data sought included demographics, level of satisfaction and questions related to their experience with virtual clinics. Computed frequencies and percentages for categorical variables, and median, mean, and standard deviation for continuous variables. Satisfaction scores were compared between groups using Mann-Whitney U test and Kruskal Wallis test. RESULTS: A total of 439 patients completed the questionnaire (response rate 97.5%); 54% were male. The participants were divided into three age groups: 18-39, 40-59, and ≥60 years. Overall level of patients' satisfaction with virtual clinic was 68.1%. Factors statistically significantly associated with satisfaction included gender, age group and level of education (post-graduate and middle school) and being well-informed on the use of telemedicine. Specific age groups that were significant were 18-39 and 40-59 years; 50.2% of the males found telemedicine very convenient, compared to only 36.1% females. Family medicine clinics were the most commonly visited virtual clinics, whereas obstetrics and gynecology clinics were the least attended virtual clinics. The inability to meet the health-care professional face-to-face was reported by 53.8% as the most important disadvantage. CONCLUSION: This study shows a high level of satisfaction with virtual clinics in Saudi Arabia during the COVID-19 pandemic despite the service being relatively new in healthcare service in the country. Our study demonstrated that satisfaction was linked to age, gender, education and the type of clinic used.

17.
Ir J Med Sci ; 190(4): 1349-1353, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1028815

ABSTRACT

INTRODUCTION: The SARS-Cov2 pandemic has caused considerable disruption to provision of routine outpatient care. This pandemic has necessitated a more modern and innovative approach to clinics, which could potentially change outpatient organisation and improve efficiency in the long term. Telephone clinics are the most practical way to deliver healthcare at a distance. AIM: The purpose of the present study was to assess patient satisfaction with a virtual telephone clinic in a tertiary referral centre for otolaryngology first during the height of the SARS-Cov2 pandemic, and subsequently at a physical follow-up appointment after easing of "lockdown" measures. METHODS: Patients were enrolled prospectively via a telephone interview over a 1-week period during the height of the "lockdown" measures, and subsequently at a physical appointment when measures eased. RESULTS: Overall, patients responded very positively in the anonymised questionnaire at the time of their virtual appointment. However, at a subsequent physical appointment, there was a reduction in overall favourable responses from patients. While patients still thought virtual clinics were a good idea and convenient in the context of SARS-Cov2, we noted a reduction in satisfaction in other key aspects of their care. Notably, patients were less likely to think that virtual clinics were able to properly address their condition. CONCLUSION: While virtual clinics remain a useful tool during the height of lockdown measures during the SARS-Cov2 pandemic, we did note a significant reduction in favourable responses to virtual appointments over physical ones upon easing of lockdown measures. Patients remained cautious in suggesting that outpatient appointments may be replaced by virtual clinics.


Subject(s)
COVID-19 , Otolaryngology , Communicable Disease Control , Humans , Pandemics , Patient Satisfaction , RNA, Viral , SARS-CoV-2 , Telephone , Tertiary Care Centers
18.
J Orthod ; 48(1): 64-73, 2021 03.
Article in English | MEDLINE | ID: covidwho-949142

ABSTRACT

OBJECTIVE: To assess satisfaction of patients and clinicians with virtual appointments using Attend Anywhere for their orthodontic consultation and to identify any areas where the technology could be further utilised. DESIGN: Service evaluation involving descriptive cross-sectional questionnaire. SETTING: Orthodontic Departments at Royal Blackburn Teaching Hospital and Burnley General Teaching Hospital. PARTICIPANTS: Patients and clinicians involved in video consultations. METHODS: Patient- and clinician-specific questionnaires were designed and those involved in virtual clinics were invited to complete these at the end of their consultation. The questionnaires focused on setting up and connecting to the virtual clinic, assessing if the correct types of patients were involved in the clinics and satisfaction with these types of remote consultations. RESULTS: A total of 121 questionnaires (59 patient and 62 clinician) were completed. Of the patients, 93% found the instructions provided to access the consultation easy to follow and 70% of clinicians did not report any connection issues. In 90% of cases, a virtual appointment was seen to be appropriate by the clinician. Respondents showed a high level of satisfaction with 76% of patients saying a remote consultation was more convenient than face-to-face, and 66% reporting they would, if appropriate, like more appointments like this in the future. CONCLUSION: The overall satisfaction among patients with virtual clinics introduced during the COVID-19 pandemic was generally high. The majority of patients would, where appropriate, prefer more virtual appointments in the future in comparison to face-to-face appointments and it was found to be more convenient for the patient.


Subject(s)
COVID-19 , Telemedicine , Cross-Sectional Studies , Humans , Pandemics , Patient Satisfaction , Personal Satisfaction , Referral and Consultation , SARS-CoV-2
20.
Int Orthop ; 44(12): 2481-2485, 2020 12.
Article in English | MEDLINE | ID: covidwho-695585

ABSTRACT

PURPOSE: The COVID pandemic has decreased orthopaedic fracture operative intervention and follow-up and increased the use of virtual telemedicine clinics. We assessed the implications of this management on future orthopaedic practice. We also surveyed patient satisfaction of our virtual fracture follow-up clinics. METHOD: We prospectively analysed 154 patients during two weeks of 'lockdown' assessing their management. We surveyed 100 virtual fracture clinic follow-up patients for satisfaction, time off work and travel. RESULTS: Forty-nine percent of patients had decisions affected by COVID. Twelve percent of patients were discharged at diagnosis having potentially unstable fractures. These were all upper limb fractures which may go onto mal-union. Twenty-nine percent of patients were discharged who would have normally had clinal or radiological follow-up. No patients had any long-term union follow-up. Virtual telemedicine clinics have been incredibly successful. The average satisfaction was 4.8/5. In only 6% of cases, the clinician felt a further face-to-face evaluation was required. Eighty-nine percent of patients would have chosen virtual follow-up under normal conditions. CONCLUSION: Lessons for the future include potentially large numbers of upper limb mal-unions which may be symptomatic. The non-union rate is likely to be the same, but these patients are unknown due to lack of late imaging. Telemedicine certainly has a role in future orthopaedic management as it is well tolerated and efficient and provides economic and environmental benefits to both clinicians and patients.


Subject(s)
COVID-19 , Fractures, Bone , Patient Care , Upper Extremity , Fractures, Bone/diagnostic imaging , Hospitals , Humans , Patient Satisfaction , Radiography , SARS-CoV-2 , Socioeconomic Factors , Surveys and Questionnaires , Upper Extremity/diagnostic imaging
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