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1.
Ann Surg ; 272(2): e168-e169, 2020 08.
Article in English | MEDLINE | ID: covidwho-705410

ABSTRACT

: The spread of COVID-19 has challenged practices across the United States to dramatically change inpatient and outpatient practices to focus on containing spread of the virus and accommodate the anticipated increase in volume of acute illness. Despite this transition, practices will need to continue to accommodate evaluation of newly diagnosed malignancies, routine postoperative visits, and acute postoperative issues. Building on an existing telemedicine framework, we aim to describe rapid transition in our outpatient care to a telehealth model in a general thoracic surgery practice during COVID-19.


Subject(s)
Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Postoperative Care , Preoperative Care , Telemedicine/organization & administration , Thoracic Surgery , Betacoronavirus , Humans , Pandemics , Philadelphia/epidemiology
3.
J Telemed Telecare ; 26(5): 309-313, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-687935

ABSTRACT

The current coronavirus (COVID-19) pandemic is again reminding us of the importance of using telehealth to deliver care, especially as means of reducing the risk of cross-contamination caused by close contact. For telehealth to be effective as part of an emergency response it first needs to become a routinely used part of our health system. Hence, it is time to step back and ask why telehealth is not mainstreamed. In this article, we highlight key requirements for this to occur. Strategies to ensure that telehealth is used regularly in acute, post-acute and emergency situations, alongside conventional service delivery methods, include flexible funding arrangements, training and accrediting our health workforce. Telehealth uptake also requires a significant change in management effort and the redesign of existing models of care. Implementing telehealth proactively rather than reactively is more likely to generate greater benefits in the long-term, and help with the everyday (and emergency) challenges in healthcare.


Subject(s)
Coronavirus Infections/epidemiology , Emergencies , Pneumonia, Viral/epidemiology , Telemedicine/organization & administration , Betacoronavirus , Humans , Pandemics
4.
G Ital Cardiol (Rome) ; 21(8): 565-569, 2020 Aug.
Article in Italian | MEDLINE | ID: covidwho-680055

ABSTRACT

In Italy, the epidemic explosion stage of COVID-19 seems to have been overcome; however, the virus has not been eradicated and the re-emergence of some outbreaks of infection substantiates the danger that the disease may persist. It is therefore necessary to keep the level of surveillance high, to maintain social distancing measures and to act in the control of disease risk factors of a serious or complicated course. Among the risk factors of severe COVID-19 in addition to age, male gender, hypertension and cardiovascular diseases, a major role seems to be played by other cardiovascular risk factors conditioned by an unhealthy lifestyle such as obesity, metabolic syndrome, diabetes and smoking. The new phase requires the maintenance of measures that avoid crowding and close interpersonal contact especially during exercise, in addition to controlled access to hospitals. This will require the reorganization of the traditional methods of cardiovascular prevention and rehabilitation activities, such as gyms and collective educational sessions, and the dilution of outpatient checks. The risk that this scenario may worsen the already suboptimal control of cardiovascular risk factors is therefore real. We do not currently know how long this new phase will last, therefore it is necessary to give impetus to new tele-health initiatives to stimulate the adoption of a healthy lifestyle in primary prevention and tele-monitoring and tele-rehabilitation programs in secondary prevention.


Subject(s)
Cardiovascular Diseases/epidemiology , Communicable Disease Control/organization & administration , Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Telemedicine/organization & administration , Cardiologists , Cardiovascular Diseases/diagnosis , Coronavirus Infections/prevention & control , Female , Follow-Up Studies , Hospitals, University , Humans , Italy/epidemiology , Male , Pandemics/prevention & control , Physician's Role , Pneumonia, Viral/prevention & control , Risk Assessment , Time Factors
5.
Adv Skin Wound Care ; 33(8): 410-417, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-671109

ABSTRACT

Telemedicine use in the field of wound care had been increasing in popularity when the novel coronavirus 2019 paralyzed the globe in early 2020. To combat the constraints of healthcare delivery during this time, the use of telemedicine has been further expanded. Although many limitations of telemedicine are still being untangled, the benefits of virtual care are being realized in both inpatient and outpatient settings. In this article, the advantages and disadvantages of telemedicine are discussed through two case examples that highlight the promise of implementation during and beyond the pandemic.


Subject(s)
Coronavirus Infections/epidemiology , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Pressure Ulcer/therapy , Surgical Wound Dehiscence/surgery , Telemedicine/organization & administration , Wound Healing/physiology , Adult , Aged , Coronavirus Infections/diagnosis , Female , Humans , Male , Outpatients/statistics & numerical data , Pneumonia, Viral/diagnosis , Pressure Ulcer/diagnosis , Quality Improvement , Risk Assessment , Surgical Wound Dehiscence/diagnosis , Treatment Outcome
6.
Farm Hosp ; 44(4): 135-140, 2020 07 01.
Article in English | MEDLINE | ID: covidwho-660916

ABSTRACT

OBJECTIVE: To analyze the status of the implementation and development of  telepharmacy as applied to the pharmaceutical care of outpatients treated at  hospital pharmacy services in Spain during the COVID-19 pandemic. METHOD: Six weeks after the beginning of the confinement period, an online 10- question survey was sent to all members of the Spanish Society of Hospital  Pharmacists. A single response per hospital was requested. The survey included  questions on the provision of remote pharmaceutical care prior to the onset of  the health crisis, patient selection criteria, procedures for home delivery of  medications and the means used to deliver them, the number of patients who  benefited from telepharmacy, and the number of referrals made. Finally,  respondents were asked whether a teleconsultation was carried out before  sending patients their medication and whether these deliveries were recorded. RESULTS: A total of 39.3% (n = 185) of all the hospitals in the National Health  System (covering all of Spain's autonomous regions) responded to the survey.  Before the beginning of the crisis, 83.2% (n = 154) of hospital pharmacy  services did not carry out remote pharmaceutical care activities that included  telepharmacy with remote delivery of medication. During the study period,  119,972 patients were treated, with 134,142 deliveries of medication being  completed. Most hospitals did not use patient selection criteria. A total of 30.2%  of hospitals selected patients based on their personal circumstances. Home  delivery and informed delivery (87%; 116,129 deliveries) was the option used in most cases. The means used to deliver the medication mainly included the use  of external courier services (47.0%; 87 hospitals) or the hospital's own transport services (38.4%; 71 hospitals). As many as 87.6% of hospitals carried out  teleconsultations prior to sending out medications and 59.6% recorded their  telepharmacy activities in the hospital pharmacy appointments record. CONCLUSIONS: The rate of implementation of telepharmacy in outpatient care in  Spain during the study period in the pandemic was high. This made it possible to guarantee the continuity of care for a large number of patients.


Subject(s)
Ambulatory Care/statistics & numerical data , Betacoronavirus , Coronavirus Infections , Pandemics , Pharmacy Service, Hospital/statistics & numerical data , Pneumonia, Viral , Telemedicine/statistics & numerical data , Health Care Surveys , Home Care Services/organization & administration , Hospital Bed Capacity , Humans , Medication Systems/organization & administration , Medication Systems/statistics & numerical data , Patient Selection , Pharmacy Service, Hospital/organization & administration , Referral and Consultation/statistics & numerical data , Spain , Telemedicine/organization & administration , Workload
8.
Gastroenterol Hepatol ; 43(6): 332-347, 2020.
Article in English, Spanish | MEDLINE | ID: covidwho-658769

ABSTRACT

The set of measures proposed by SEPD, AEEH, GETECCU and AEG are aimed to help departments in their resumption of usual activity. We have prepared a number of practical recommendations regarding patient management and the stepwise resumption of healthcare activity. These recommendations are based on the sparse, changing evidence available, and will be updated in the future according to daily needs and the availability of expendable materials to suit them; in each department they will be implemented depending upon the cumulative incidence of SARS-CoV-2 infection in each region, and the burden the pandemic has represented for each hospital. The general objectives of these recommendations include: (a)To protect our patients against the risks of infection with SARS-CoV-2 and to provide them with high-quality care. (b)To protect all healthcare professionals against the risks of infection with SARS-CoV-2. (c)To resume normal functioning of our departments in a setting of ongoing risk for infection with SARS-CoV-2.


Subject(s)
Coronavirus Infections/prevention & control , Gastroenterology/organization & administration , Hospital Departments/organization & administration , Infection Control/organization & administration , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Appointments and Schedules , Clinical Laboratory Techniques , Clinical Trials as Topic , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Coronavirus Infections/transmission , Cross Infection/prevention & control , Diagnostic Techniques, Digestive System/instrumentation , Digestive System Diseases/complications , Digestive System Diseases/diagnosis , Digestive System Diseases/therapy , Disinfection , Drug Interactions , Equipment Contamination/prevention & control , Home Care Services/organization & administration , Humans , Immunocompromised Host , Immunosuppressive Agents/adverse effects , Immunosuppressive Agents/therapeutic use , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Infectious Disease Transmission, Professional-to-Patient/prevention & control , Liver Transplantation , Mass Screening/organization & administration , Occupational Diseases/prevention & control , Pneumonia, Viral/drug therapy , Pneumonia, Viral/transmission , Protective Devices , Symptom Assessment , Telemedicine/organization & administration , Universal Precautions
9.
Am J Pharm Educ ; 84(6): ajpe8158, 2020 06.
Article in English | MEDLINE | ID: covidwho-646817

ABSTRACT

The novel coronavirus identified in 2019 (COVID-19) pandemic has impacted pharmacy graduate and postgraduate education. This crisis has resulted in a cosmic shift in the administration of these programs to ensure core values are sustained. Adjustments may be needed at a minimum to ensure that postgraduate trainees complete program requirements while maintaining safety. Moving forward, additional issues may arise that will need to be addressed such as admissions and program onboarding, acclimating students to new training environments, and managing inadequate resources for distance education, distance practice, and remote versus in-person research opportunities.


Subject(s)
Coronavirus Infections/epidemiology , Education, Graduate/organization & administration , Education, Pharmacy/organization & administration , Pneumonia, Viral/epidemiology , Betacoronavirus , Education, Distance , Education, Graduate/standards , Education, Pharmacy/standards , Humans , Interprofessional Relations , Pandemics , Patient Care Team/organization & administration , Pharmacy Residencies/organization & administration , Research/organization & administration , School Admission Criteria , Teaching/organization & administration , Telemedicine/organization & administration
10.
Farm Hosp ; 44(4): 135-140, 2020 07 01.
Article in English | MEDLINE | ID: covidwho-640386

ABSTRACT

OBJECTIVE: To analyze the status of the implementation and development of  telepharmacy as applied to the pharmaceutical care of outpatients treated at  hospital pharmacy services in Spain during the COVID-19 pandemic. METHOD: Six weeks after the beginning of the confinement period, an online 10- question survey was sent to all members of the Spanish Society of Hospital  Pharmacists. A single response per hospital was requested. The survey included  questions on the provision of remote pharmaceutical care prior to the onset of  the health crisis, patient selection criteria, procedures for home delivery of  medications and the means used to deliver them, the number of patients who  benefited from telepharmacy, and the number of referrals made. Finally,  respondents were asked whether a teleconsultation was carried out before  sending patients their medication and whether these deliveries were recorded. RESULTS: A total of 39.3% (n = 185) of all the hospitals in the National Health  System (covering all of Spain's autonomous regions) responded to the survey.  Before the beginning of the crisis, 83.2% (n = 154) of hospital pharmacy  services did not carry out remote pharmaceutical care activities that included  telepharmacy with remote delivery of medication. During the study period,  119,972 patients were treated, with 134,142 deliveries of medication being  completed. Most hospitals did not use patient selection criteria. A total of 30.2%  of hospitals selected patients based on their personal circumstances. Home  delivery and informed delivery (87%; 116,129 deliveries) was the option used in most cases. The means used to deliver the medication mainly included the use  of external courier services (47.0%; 87 hospitals) or the hospital's own transport services (38.4%; 71 hospitals). As many as 87.6% of hospitals carried out  teleconsultations prior to sending out medications and 59.6% recorded their  telepharmacy activities in the hospital pharmacy appointments record. CONCLUSIONS: The rate of implementation of telepharmacy in outpatient care in  Spain during the study period in the pandemic was high. This made it possible to guarantee the continuity of care for a large number of patients.


Subject(s)
Ambulatory Care/statistics & numerical data , Betacoronavirus , Coronavirus Infections , Pandemics , Pharmacy Service, Hospital/statistics & numerical data , Pneumonia, Viral , Telemedicine/statistics & numerical data , Health Care Surveys , Home Care Services/organization & administration , Hospital Bed Capacity , Humans , Medication Systems/organization & administration , Medication Systems/statistics & numerical data , Patient Selection , Pharmacy Service, Hospital/organization & administration , Referral and Consultation/statistics & numerical data , Spain , Telemedicine/organization & administration , Workload
12.
J Cosmet Dermatol ; 19(7): 1544, 2020 Jul.
Article in English | MEDLINE | ID: covidwho-637389

ABSTRACT

COVID-19 presents many pressing challenges to the global dermatological community and our patients with ongoing skin needs, which must be considered by every dermatology provider. Many of these are logistical and administrative, distinct from physical manifestations, and could be summarized by the acronym COVID (Consultations, Operations, Videoconferencing, Immunosuppressive medications, Drug and equipment shortages). While the pandemic may represent a threat to many parts of our existence, dermatologists can help the patients we care for by considering noncutaneous implications of COVID-19 upon our practice.


Subject(s)
Communicable Disease Control/organization & administration , Coronavirus Infections/prevention & control , Dermatology/organization & administration , Outcome Assessment, Health Care , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Telemedicine/organization & administration , Coronavirus Infections/epidemiology , Female , Global Health , Humans , Male , Pandemics/statistics & numerical data , Pneumonia, Viral/epidemiology , Practice Management, Medical/trends , Risk Assessment , Videoconferencing
15.
Afr J Prim Health Care Fam Med ; 12(1): e1-e3, 2020 Jun 18.
Article in English | MEDLINE | ID: covidwho-635692

ABSTRACT

The Coronavirus disease 2019 (COVID-19) pandemic has been ravaging Nigeria and the world with increasing morbidity and mortality. Despite efforts by the Nigerian government implemented through the Nigerian Centre for Disease Control (NCDC) to reduce the scourge of the disease through public enlightenment and regular updates, the number of new cases and mortalities from COVID-19 are still increasing. Family physicians (FPs) who are the first contact of care for most patients accessing private and public health facilities in Nigeria have been working tirelessly to reduce the scourge of the pandemic in Nigeria. They continuously update themselves through regular webinars and online resources and guidelines provided by the Society of Family Physicians of Nigeria (SOFPON). Measures adopted by FPs across the country in the fight against the scourge include triaging patients as they present to the family medicine clinics; health education and enlightenment of the populace; and ensuring social distancing, regular handwashing and compulsory use of face mask by both physicians and patients during clinical consultations. Other measures include incorporating family-focused behavioural interventions in their practice, home-based care to reduce the number of persons visiting the hospital, telemedicine and Hospice and palliative care services to the elderly and terminally ill. In conclusion, FPs in Nigeria are helping to reduce the scourge of COVID-19 through patient education and innovative healthcare delivery that does not put patients at increased risk of the disease whilst promptly recognising potential COVID-19 patients and referring them for early diagnosis and treatment.


Subject(s)
Coronavirus Infections/therapy , Family Practice/organization & administration , Physician's Role , Pneumonia, Viral/therapy , Primary Prevention/organization & administration , Betacoronavirus , Health Personnel/psychology , Humans , Nigeria , Pandemics , Physicians, Family , Telemedicine/organization & administration
16.
Pediatr Obes ; 15(8): e12694, 2020 08.
Article in English | MEDLINE | ID: covidwho-634553

ABSTRACT

Telemedicine is a powerful tool that erases many logistical barriers to care and may increase access. Due to the need for social distancing, the COVID-19 pandemic has temporarily reduced in-person visits for clinical care. Providers, clinical staff and patients are pressed to acutely learn new skills and adapt clinical care through the use of telemedicine whilst administrators, policy makers and regulatory organizations make changes to existing policies to meet this national emergency. Our tertiary care, interdisciplinary paediatric weight management clinic began the use of telemedicine 5 years ago to bring access to an underserved, rural population at their primary care office, which has allowed our clinic to pivot seamlessly to in-home telemedicine visits during the pandemic. Telemedicine rules and regulations are rapidly changing to meet the COVID-19 national emergency, but many supports for new telemedicine providers are already in place. In this article, we provide an overview of telemedicine components, policies and regulations. We review the operationalization of our clinic's telemedicine visit prior to the pandemic. We discuss how telemedicine services are impacted by COVID-19 and key resources are provided. Finally, we reimagine telemedicine services post-pandemic to expand effective, coordinated health care, particularly for patients with chronic needs such as obesity.


Subject(s)
Coronavirus Infections/epidemiology , Pediatric Obesity/therapy , Pneumonia, Viral/epidemiology , Telemedicine/organization & administration , Betacoronavirus , Child , Humans , Office Visits , Pandemics
18.
J Aging Soc Policy ; 32(4-5): 460-470, 2020.
Article in English | MEDLINE | ID: covidwho-628988

ABSTRACT

Older adults are in triple jeopardy during COVID-19: compared with younger people, older adults are (1) more likely to develop serious conditions and experience higher mortality; (2) less likely to obtain high quality information or services online; and (3) more likely to experience social isolation and loneliness. Hybrid solutions, coupling online and offline strategies, are invaluable in ensuring the inclusion of vulnerable populations. Most of these solutions require no new inventions. Finding the financial resources for a rapid, well-coordinated implementation is the biggest challenge. Setting up the requisite support systems and digital infrastructure is important for the present and future pandemics.


Subject(s)
Coronavirus Infections/epidemiology , Internet , Pneumonia, Viral/epidemiology , Social Participation , Aged , Aged, 80 and over , Betacoronavirus , Computers , Consumer Health Information/methods , Family , Food Supply/methods , Humans , Information Dissemination , Middle Aged , Pandemics , Social Isolation , Social Support , Telemedicine/organization & administration
20.
J Adolesc Health ; 67(2): 172-178, 2020 08.
Article in English | MEDLINE | ID: covidwho-626700

ABSTRACT

PURPOSE: To describe the first 30 days of rapid adolescent telehealth scale-up in response to the coronavirus (COVID-19) pandemic at a single academic medical center and assess for disparities in visit completion rates by patient characteristics. METHODS: Visit outcome and patient demographic data were obtained via electronic health record (EHR) reports. Telehealth visit completion rates were compared by patient characteristics using the chi-square test and t-test. We used zip code data to generate latitude- and longitude-based maps of the range and density of service delivery. Patient cases highlighting challenges and opportunities for adolescent telehealth were summarized. RESULTS: Between March 16 and April 15, 2020, 392 telehealth visits were scheduled in 331 unique patients, with an 82% appointment completion rate. Video visits were conducted for eating disorders (39%), contraception/menstrual disorders (22%), gender-affirming care (17%), general adolescent medicine (15%), HIV treatment (6%), and substance abuse (1%). The majority of telehealth patients were female Caucasian minors with private insurance. There were no significant differences in telehealth visit completion rates by age, sex, gender, or insurance. Patients coded as non-white (African-American, Asian, or other) in the EHR had lower visit completion rates than white patients (p = .003). Telehealth patients were distributed across five states, with the highest concentration in the zip codes nearest to the clinic. CONCLUSIONS: Rapid scale-up of telehealth for Adolescent Medicine was achieved at this large academic medical center. Future implementation research is needed to assure telehealth reaches adolescents without widening health disparities.


Subject(s)
Adolescent Health Services , Coronavirus Infections/epidemiology , Pandemics , Pneumonia, Viral/epidemiology , Telemedicine/organization & administration , Adolescent , Female , Healthcare Disparities , Humans , Male , Outcome Assessment, Health Care , Telemedicine/statistics & numerical data
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