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Urology ; 153: 35-41, 2021 07.
Article in English | MEDLINE | ID: covidwho-1065641


OBJECTIVE: To evaluate patient satisfaction with telemedicine appointments as an alternative to in-person appointments at an Andrology-focused academic urology practice during the coronavirus disease 2019 pandemic. METHODS: Between March and June 2020, all appointments at the practice of a single Andrology-focused academic urologist were conducted by telephone. Consecutive patients were contacted by telephone following their appointment to complete a telephone questionnaire. Baseline demographic information was obtained, and perceptions regarding telephone appointments were assessed using a Likert scale. RESULTS: Ninety-six patients completed the telephone questionnaire. Median age was 48.5 years (interquartile range 37.3-62.8 years) with 55 of 96 (57.3%) of the appointments Andrology-focused. Mean distance of residence from the hospital was 8.4 km (interquartile range 4.7-25.2 km). Only 9 of 96 (9.3%) of the patients felt that the telephone format did not adequately address their needs. However, 26 of 96 (27.1%) of patients said they would prefer an in-person appointment. On multivariable analysis adjusting for age, gender, presenting complaint, type of appointment, education level, and employment status, no factors were associated with feeling that the telephone appointment adequately addressed needs or preference for an in-person appointment in the future. CONCLUSION: Patients were generally satisfied with telephone appointments as an alternative to in-person appointments during the coronavirus disease 2019 pandemic. Nonetheless, a substantial portion of patients said they would prefer in-person appointments in the future.

COVID-19/prevention & control , Office Visits , Patient Preference/statistics & numerical data , Telemedicine , Urology/statistics & numerical data , Adult , Andrology , Employment , Female , Female Urogenital Diseases/therapy , Humans , Male , Male Urogenital Diseases/therapy , Middle Aged , Office Visits/economics , SARS-CoV-2 , Surveys and Questionnaires , Telephone
Fertil Steril ; 114(6): 1126-1128, 2020 12.
Article in English | MEDLINE | ID: covidwho-959775


Telemedicine had been very slowly making inroads into standard clinical practice. The onset of the COVID-19 pandemic resulted in the rapid implementation of telemedicine across most practices. The efficiency and permanence of telemedicine services depends on a multitude of factors including technologic choices, governmental and insurance regulations, reimbursement policies, and staff and patient education and acceptance. Although challenges remain and the extent of implementation is still evolving, it is clear that telemedicine is here to stay and that all those involved in health care need to be familiar with its opportunities and challenges.

COVID-19 , Reproductive Medicine , SARS-CoV-2 , Telemedicine , Health Insurance Portability and Accountability Act , Humans , Insurance, Health, Reimbursement/legislation & jurisprudence , Office Visits/economics , Office Visits/trends , Patient Education as Topic , Personnel Staffing and Scheduling , Reproductive Medicine/instrumentation , Reproductive Medicine/methods , Reproductive Medicine/trends , Telemedicine/instrumentation , Telemedicine/methods , Telemedicine/trends , United States
Prenat Diagn ; 40(10): 1265-1271, 2020 09.
Article in English | MEDLINE | ID: covidwho-343193


OBJECTIVE: Advances in prenatal genetics place additional challenges as patients must receive information about a growing array of screening and testing options. This raises concerns about how to achieve a shared decision-making process that prepares patients to make an informed decision about their choices about prenatal genetic screening and testing options, calling for a reconsideration of how healthcare providers approach the first prenatal visit. METHODS: We conducted interviews with 40 pregnant women to identify components of decision-making regarding prenatal genetic screens and tests at this visit. Analysis was approached using grounded theory. RESULTS: Participants brought distinct notions of risk to the visit, including skewed perceptions of baseline risk for a fetal genetic condition and the implications of screening and testing. Participants were very concerned about financial considerations associated with these options, ranking out-of-pocket costs on par with medical considerations. Participants noted diverging priorities at the first visit from those of their healthcare provider, leading to barriers to shared decision-making regarding screening and testing during this visit. CONCLUSION: Research is needed to determine how to restructure the initiation of prenatal care in a way that best positions patients to make informed decisions about prenatal genetic screens and tests.

Decision Making , Genetic Testing , Prenatal Care , Adult , Attitude to Health , Cell-Free Nucleic Acids/analysis , Cell-Free Nucleic Acids/blood , Female , Genetic Testing/economics , Genetic Testing/methods , Genetic Testing/standards , Humans , Mass Screening/economics , Mass Screening/organization & administration , Mass Screening/psychology , Mass Screening/standards , Maternal Serum Screening Tests/economics , Maternal Serum Screening Tests/psychology , Maternal Serum Screening Tests/standards , Office Visits/economics , Patient Participation/psychology , Patient Participation/statistics & numerical data , Perception , Pregnancy , Prenatal Care/economics , Prenatal Care/organization & administration , Prenatal Care/psychology , Prenatal Care/standards , Prenatal Diagnosis/economics , Prenatal Diagnosis/methods , Prenatal Diagnosis/psychology , Prenatal Diagnosis/standards , Risk Assessment , United States