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1.
Ital J Pediatr ; 47(1): 29, 2021 Feb 12.
Article in English | MEDLINE | ID: covidwho-1082904

ABSTRACT

BACKGROUND: Suspending ordinary care activities during the COVID-19 pandemic made it necessary to find alternative routes to comply with care recommendations not only for acute health needs but also for patients requiring follow-up and multidisciplinary visits. We present the 'Contactless' model, a comprehensive operational tool including a plurality of services delivered remotely, structured according to a complexity gradient, aimed to cover diagnostic procedures and monitor disease progression in chronic pediatric patients. METHODS: A multidisciplinary and multiprofessional project team was recruited, in collaboration with patients' associations, to map a panel of available Evidence-Based solutions and address individual needs in full respect of the concept of personalized medicine. The solutions include a number of services from videoconsultations to more structure videotraining sessions. RESULTS: A modular framework made up of four three Macro-levels of complexity - Contactless Basic, Intermediate and Advanced - was displayed as an incremental set of services and operational planning establishing each phase, from factors influencing eligibility to the delivery of the most accurate and complex levels of care. CONCLUSION: The multimodal, multidisciplinary 'Contactless' model allowed the inclusion of all Units of our Pediatric Department and families with children with disability or complex chronic conditions. The strengths of this project rely on its replicability outside of pediatrics and in the limited resources needed to practically impact patients, caregivers and professionals involved in the process of care. Its implementation in the future may contribute to reduce the duration of hospital admissions, money and parental absence from work.


Subject(s)
/epidemiology , Delivery of Health Care/organization & administration , Disabled Children , Models, Organizational , Pediatrics/organization & administration , Telemedicine/organization & administration , Child , Chronic Disease , Humans , Pandemics , Program Development
3.
Epidemiol Prev ; 44(5-6 Suppl 2): 383-393, 2020.
Article in Italian | MEDLINE | ID: covidwho-1068161

ABSTRACT

The area of mental health is directly affected by the pandemic and its consequences, for various reasons: 1-the pandemic triggered a global lockdown, with dramatic socioeconomic and therefore psychosocial implications; 2-mental health services, which treat by definition a fragile population from the psychological, biological and social points of view, have a complex organizational frame, and it was expected that this would be affected (or overwhelmed) by the pandemic; 3-mental health services should, at least in theory, be able to help guide public health policies when these involve a significant modification of individual behaviour. It was conducted a narrative review of the publications produced by European researchers in the period February-June 2020 and indexed in PubMed. A total of 34 papers were analyzed, which document the profound clinical, organizational and procedural changes introduced in mental health services following this exceptional and largely unforeseen planetary event.Among the main innovations recorded everywhere, the strong push towards the use of telemedicine techniques should be mentioned: however, these require an adequate critical evaluation, which highlights their possibilities, limits, advantages and disadvantages instead of simple triumphalist judgments. Furthermore, should be emphasized the scarcity of quantitative studies conducted in this period and the absence of studies aimed, for example, at exploring the consequences of prolonged and forced face-to-face contact between patients and family members with a high index of "expressed emotions".


Subject(s)
Bibliometrics , Mental Health Services , Pandemics , Adolescent , Adolescent Health Services/statistics & numerical data , Adolescent Health Services/supply & distribution , /psychology , Child , Child Health Services/statistics & numerical data , Child Health Services/supply & distribution , Europe/epidemiology , Expressed Emotion , Feeding and Eating Disorders/epidemiology , Forensic Psychiatry/organization & administration , Health Policy , Health Services Needs and Demand , Health Services for the Aged/statistics & numerical data , Health Services for the Aged/supply & distribution , Humans , Interpersonal Relations , Mental Disorders/epidemiology , Mental Disorders/etiology , Mental Health Services/statistics & numerical data , Mental Health Services/supply & distribution , Observational Studies as Topic , Procedures and Techniques Utilization , PubMed , Quarantine , Telemedicine/organization & administration , Telemedicine/statistics & numerical data
5.
JMIR Mhealth Uhealth ; 9(2): e25960, 2021 02 05.
Article in English | MEDLINE | ID: covidwho-1067584

ABSTRACT

BACKGROUND: Online hospitals are part of an innovative model that allows China to explore telemedicine services based on national conditions with large populations, uneven distribution of medical resources, and lack of quality medical resources, especially among residents needing to be protected from COVID-19 infection. OBJECTIVE: In this study, we built a hypothesis model based on the Unified Theory of Acceptance and Use of Technology (UTAUT) in order to analyze the factors that may influence patients' willingness to use mobile medical services. This research was designed to assist in the development of mobile medical services. Residents who do not live in urban areas and cannot access medical assistance would greatly benefit from this research, as they could immediately go to the online hospital when needed. METHODS: A cross-sectional study based at the West China Hospital, Sichuan University, was conducted in July 2020. A total of 407 respondents, 18 to 59 years old, in Western China were recruited by convenience sampling. We also conducted an empirical test for the hypothesis model and applied structural equation modeling to estimate the significance of path coefficients so that we could better understand the influencing factors. RESULTS: Out of 407 respondents, 95 (23.3%) were aware of online hospitals, while 312 (76.7%) indicated that they have never heard of online hospitals before. Gender (P=.048) and education level (P=.04) affected people's willingness to use online hospitals, and both of these factors promoted the use of online hospitals (odds ratio [OR] 2.844, 95% CI 1.010-8.003, and OR 2.187, 95% CI 1.031-4.636, respectively). According to structural equation modeling, the results of the path coefficient analysis indicated that performance expectancy, effort expectancy, and facilitating conditions have positive effects on patients' willingness to use online hospitals. CONCLUSIONS: The goal of our research was to determine the factors that influence patients' awareness and willingness to use online hospitals. Currently, the public's awareness and usage of online hospitals is low. In fact, effort expectancy was the most important factor that influenced the use of online hospitals; being female and having a high education also played positive roles toward the use of mobile medical services.


Subject(s)
Health Knowledge, Attitudes, Practice , Hospitals , Patient Acceptance of Health Care/statistics & numerical data , Telemedicine/organization & administration , Telemedicine/statistics & numerical data , Adolescent , Adult , China/epidemiology , Cross-Sectional Studies , Female , Health Care Surveys , Humans , Male , Middle Aged , Socioeconomic Factors , Young Adult
6.
Ann Clin Psychiatry ; 33(1): 27-34, 2021 02.
Article in English | MEDLINE | ID: covidwho-1059657

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic brought many challenges to patient care delivery. The need for social distancing and relaxing of federal and state telemental health regulations paved the way for widespread adoption of direct-to-consumer (DTC) ambulatory mental health video visits. METHODS: We present cases that demonstrate the use of video visits across 6 clinical areas, each serving a unique population of patients, in a large behavioral health system. The benefits and limitations of this modality are illustrated in children, adults, and older adults with mood disorders, anxiety disorders, intellectual disability, substance use disorders, neurocognitive disorders, and schizophrenia. RESULTS: Although telephone visits were acceptable and necessary to serve some patients, there are many advantages to video visits in providing best patient care. Education and support for telemental health-delivered to both patients and clinicians-is critical to the success of the DTC model. CONCLUSIONS: DTC telemental health is a widespread clinical tool used during the COVID-19 pandemic. Because this model has many strengths and advantages compared with traditional telemental health delivered in a clinic, regulators and insurers should be open to its continued use postpandemic when clinically appropriate.


Subject(s)
Mental Disorders/therapy , Mental Health Services , Telemedicine , Adolescent , Adult , Aged , Child , Female , Humans , Male , Mental Health Services/organization & administration , Mental Health Services/standards , Middle Aged , Telemedicine/organization & administration , Telemedicine/standards , Telephone , Videoconferencing , Young Adult
7.
Acta Biomed ; 91(4): ahead of print, 2020 07 13.
Article in English | MEDLINE | ID: covidwho-1058708

ABSTRACT

COVID-19 has impacted the primary management of cardiac conditions, decreasing the number of interventions of coronary diseases. Elective coronary treatments and imaging have been largely cancelled across the world to make way for increased resources for COVID-19 patients. The impact on these cardiac patients during these times may be drastic. The number of hospital patients presenting with coronary symptoms during the outbreak has also decreased internationally. In this review, we discuss how COVID-19 has affected primary cardiac intervention globally and our service, possible reasons why, and how morbidity rates can be reduced by introducing scoring systems and telemedicine.


Subject(s)
/epidemiology , Cardiology/organization & administration , Telemedicine/organization & administration , /prevention & control , Cardiac Imaging Techniques , Cardiac Surgical Procedures , Humans , Practice Patterns, Physicians'
8.
J Nerv Ment Dis ; 209(2): 144-146, 2021 02 01.
Article in English | MEDLINE | ID: covidwho-1050216

ABSTRACT

ABSTRACT: To date, there is lack of specific effective treatment or vaccine for the SARS-CoV-2, and clinical and laboratory research is still ongoing to find successful drugs. Therefore, prevention to be infected through social distancing and isolation is the most effective way. However, all the other physical and mental illnesses continue to exist, if possible even more burdened by the emergency situation and social distancing. The COVID-19 pandemic, especially in many low- and middle-income countries, has caused a deeper gap in seeking psychiatric help. In this scenario, telepsychiatry could play a decisive role in implementing clinical care for frail patients and ensuring continuous mental care. Therefore, we felt the urge to write this article to express our hope that the old health care system at this time of crisis, as we know it, can offer the chance to implement pervasive care technologies that perfectly fit current psychiatric needs.


Subject(s)
/prevention & control , Developing Countries , Health Services Accessibility , Mental Disorders/therapy , Mental Health Services , Telemedicine , Continuity of Patient Care/standards , Health Services Accessibility/organization & administration , Health Services Accessibility/standards , Humans , Mental Health Services/organization & administration , Mental Health Services/standards , Mobile Applications , Psychiatry/organization & administration , Psychiatry/standards , Telemedicine/organization & administration , Telemedicine/standards
9.
J Med Internet Res ; 23(2): e22189, 2021 02 05.
Article in English | MEDLINE | ID: covidwho-1045554

ABSTRACT

One Digital Health is a proposed unified structure. The conceptual framework of the One Digital Health Steering Wheel is built around two keys (ie, One Health and digital health), three perspectives (ie, individual health and well-being, population and society, and ecosystem), and five dimensions (ie, citizens' engagement, education, environment, human and veterinary health care, and Healthcare Industry 4.0). One Digital Health aims to digitally transform future health ecosystems, by implementing a systemic health and life sciences approach that takes into account broad digital technology perspectives on human health, animal health, and the management of the surrounding environment. This approach allows for the examination of how future generations of health informaticians can address the intrinsic complexity of novel health and care scenarios in digitally transformed health ecosystems. In the emerging hybrid landscape, citizens and their health data have been called to play a central role in the management of individual-level and population-level perspective data. The main challenges of One Digital Health include facilitating and improving interactions between One Health and digital health communities, to allow for efficient interactions and the delivery of near-real-time, data-driven contributions in systems medicine and systems ecology. However, digital health literacy; the capacity to understand and engage in health prevention activities; self-management; and collaboration in the prevention, control, and alleviation of potential problems are necessary in systemic, ecosystem-driven public health and data science research. Therefore, people in a healthy One Digital Health ecosystem must use an active and forceful approach to prevent and manage health crises and disasters, such as the COVID-19 pandemic.


Subject(s)
/epidemiology , One Health , Telemedicine/organization & administration , Humans , Pandemics , /isolation & purification
12.
Bull World Health Organ ; 98(11): 731-732, 2020 Nov 01.
Article in English | MEDLINE | ID: covidwho-1024481

ABSTRACT

The novel coronavirus pandemic is increasing demand for digital health in primary care delivery, highlighting the progress being made and the challenges still faced. Gary Humphreys reports.


Subject(s)
Coronavirus Infections/epidemiology , Hotlines/organization & administration , Pneumonia, Viral/epidemiology , Telemedicine/organization & administration , Betacoronavirus , Humans , Mobile Applications , Pandemics , Sri Lanka/epidemiology
13.
MMWR Morb Mortal Wkly Rep ; 69(50): 1902-1905, 2020 Dec 18.
Article in English | MEDLINE | ID: covidwho-1016443

ABSTRACT

Early in the coronavirus disease 2019 (COVID-19) pandemic, in-person ambulatory health care visits declined by 60% across the United States, while telehealth* visits increased, accounting for up to 30% of total care provided in some locations (1,2). In March 2020, the Centers for Medicare & Medicaid Services (CMS) released updated regulations and guidance changing telehealth provisions during the COVID-19 Public Health Emergency, including the elimination of geographic barriers and enhanced reimbursement for telehealth services† (3-6). The Health Resources and Services Administration (HRSA) administers a voluntary weekly Health Center COVID-19 Survey§ to track health centers' COVID-19 testing capacity and the impact of COVID-19 on operations, patients, and staff. CDC and HRSA analyzed data from the weekly COVID-19 survey completed by 1,009 HRSA-funded health centers (health centers¶) for the week of July 11-17, 2020, to describe telehealth service use in the United States by U.S. Census region,** urbanicity,†† staffing capacity, change in visit volume, and personal protective equipment (PPE) supply. Among the 1,009 health center respondents, 963 (95.4%) reported providing telehealth services. Health centers in urban areas were more likely to provide >30% of health care visits virtually (i.e., via telehealth) than were health centers in rural areas. Telehealth is a promising approach to promoting access to care and can facilitate public health mitigation strategies and help prevent transmission of SARS-CoV-2 and other respiratory illnesses, while supporting continuity of care. Although CMS's change of its telehealth provisions enabled health centers to expand telehealth by aligning guidance and leveraging federal resources, sustaining expanded use of telehealth services might require additional policies and resources.


Subject(s)
Health Facilities/statistics & numerical data , Telemedicine/statistics & numerical data , Health Care Surveys , Health Services Accessibility , Humans , Telemedicine/organization & administration , United States/epidemiology
14.
BMC Musculoskelet Disord ; 22(1): 18, 2021 Jan 05.
Article in English | MEDLINE | ID: covidwho-1011199

ABSTRACT

BACKGROUND: Like with all cancers, multidisciplinary team (MDT) meetings are the norm in bone and soft tissue tumour (BST) management too. Problem in attendance of specialists due to geographical location is the one of the key barriers to effective functioning of MDTs. To overcome this problem, virtual MDTs involving videoconferencing or telemedicine have been proposed, but however this has been seldom used and tested. The COVID-19 pandemic forced the implementation of virtual MDTs in the Oxford sarcoma service in order to maintain normal service provision. We conducted a survey among the participants to evaluate its efficacy. METHODS: An online questionnaire comprising of 24 questions organised into 4 sections was circulated among all participants of the MDT after completion of 8 virtual MDTs. Opinions were sought comparing virtual MDTs to the conventional face-to-face MDTs on various aspects. A total of 36 responses were received and were evaluated. RESULTS: 72.8% were satisfied with the depth of discussion in virtual MDTs and 83.3% felt that the decision-making in diagnosis had not changed following the switch from face-to-face MDTs. About 86% reported to have all essential patient data was available to make decisions and 88.9% were satisfied with the time for discussion of patient issues over virtual platform. Three-fourths of the participants were satisfied (36.1% - highly satisfied; 38.9% - moderately satisfied) with virtual MDTs and 55.6% of them were happy to attend MDTs only by the virtual platform in the future. Regarding future, 77.8% of the participants opined that virtual MDTs would be the future of cancer care and an overwhelming majority (91.7%) felt that the present exercise would serve as a precursor to global MDTs involving specialists from abroad in the future. CONCLUSION: Our study shows that the forced switch to virtual MDTs in sarcoma care following the unprecedented COVID-19 pandemic to be a viable and effective alternative to conventional face-to-face MDTs. With effective and efficient software in place, virtual MDTs would also facilitate in forming extended MDTs in seeking opinions on complex cases from specialists abroad and can expand cancer care globally.


Subject(s)
Bone Neoplasms/therapy , Interdisciplinary Communication , Medical Oncology/organization & administration , Muscle Neoplasms/therapy , Patient Care Team/organization & administration , Sarcoma/therapy , Telemedicine/organization & administration , Videoconferencing/organization & administration , Attitude of Health Personnel , Attitude to Computers , Bone Neoplasms/diagnosis , Clinical Decision-Making , Delivery of Health Care, Integrated/organization & administration , Health Knowledge, Attitudes, Practice , Humans , Muscle Neoplasms/diagnosis , Sarcoma/diagnosis , Tertiary Care Centers
15.
Work ; 67(1): 29-35, 2020.
Article in English | MEDLINE | ID: covidwho-1007030

ABSTRACT

BACKGROUND: Prior to the COVID-19 global health emergency, telehealth was an emerging occupational therapy (OT) service delivery model possessing many positive attributes. These include the potential to offset well-documented global occupational therapy practitioner (OTP) shortages. However, wide-spread adoption of telehealth as a delivery model in school-based practice is lacking in the OT evidence literature. While the COVID-19 global health emergency propelled many OTPs into the use of telehealth technologies, in some cases with minimal preparation, an investigation was conducted into the likelihood of telehealth adoption when comprehensive training was provided so that appropriateness of student fit for telehealth could be determined and essential planning could take place. OBJECTIVE: Prior to the COVID-19 global health emergency, a comprehensive training program was developed incorporating detailed perceptions of OTPs experienced in and new to telehealth in school-based practice as measured via surveys with the goal of increasing adoption of telehealth technologies for the delivery of OT services. Following the completion of the online New to Telehealth Pre-training Survey, OTPs new to telehealth were invited to complete the OT Telehealth Primer: School-based Practice training program. Analysis of pre- and post-training surveys yielded information about attitudinal changes experienced post-training. METHODS: Prior to the COVID-19 global health emergency, school-based occupational therapy practitioners (OTP) experienced in telehealth were invited to complete a survey exploring benefits and barriers encountered in the delivery of OT services using telehealth. OTPs new-to-telehealth were invited to complete a different survey intended to explore attitudes about the potential use of telehealth. Data collected from both surveys were used to develop a comprehensive training program, The OT Telehealth Primer for School-based Practice. OTPs new-to-telehealth were invited to complete the training program and a post-training survey. A descriptive data analysis was completed on responses from pre- to post-training surveys and the chi-square test of independence was used to evaluate difference in reported likelihood of adopting telehealth into practice before and after training. RESULTS: Prior to the COVID-19 global health emergency, the top benefits identified by the OTP Experienced Telehealth-User Survey included: 1) service access, 2) collaboration and carry-over with team members, 3) efficiency themes, and4) student engagement and comfort. Top benefits identified by the OTP New to Telehealth Survey identified the same top benefits after participating in the training program. A significant decrease in perceived barriers was noted in scores from pre- to post-training by OTPs new to telehealth. The perceived barriers that did not significantly decrease post-training suggest the need for future education and future protocol development. These included: unreliable internet, lack of hands-on opportunity and e-helpers' (parent, caregiver or support system available to assist the student in person during a telehealth session) decreased comfort with technology. Of the participants who completed the OT Telehealth Primer: School-based Practice, 80% reported being likely to add telehealth as a delivery model for future OT practice. CONCLUSIONS: Prior to the COVID-19 global health emergency, completion of the comprehensive training program OT Telehealth Primer: School-based Practice program yielded improved perceived benefits and an increased likelihood of telehealth adoption into practice by OTPs. However, both OTPs and school administrators require ongoing education for successful widespread adoption to be achieved thus offsetting the global shortage of OTPs and increasing service access. Future research, particularly related to available training and support for the rapid adoption of telehealth technologies during the COVID-19 global health emergency, will yield helpful information about the likelihood of continued use of telehealth in practice.


Subject(s)
Coronavirus Infections/epidemiology , Health Workforce , Occupational Therapy/organization & administration , Pandemics , Pneumonia, Viral/epidemiology , School Health Services/organization & administration , Telemedicine/organization & administration , Betacoronavirus , Efficiency, Organizational , Global Health , Health Services Accessibility , Humans , Interdisciplinary Communication , Occupational Therapy/statistics & numerical data , Patient Care Team
16.
Am J Manag Care ; 26(10 Spec No.): SP330-SP332, 2020 12.
Article in English | MEDLINE | ID: covidwho-1006072

ABSTRACT

PURPOSE: To describe onboarding and utilization of telemedicine across a large statewide community oncology practice and to evaluate trends, barriers, and opportunities in care delivery during the coronavirus disease 2019 pandemic. METHODS: We describe telemedicine onboarding and utilization across a statewide oncology practice, covering 221 sites of service and more than 650 practitioners. We describe qualitatively the onboarding process of a diverse set of administrative, technical, and clinical partners. We describe quantitatively utilization throughout the practice. We describe a survey conducted to enlighten barriers and opportunities for optimal utilization. RESULTS: Multistakeholder education was directed to clinical teams, administrative and technical support staff, and patients through webinars and team meetings. Utilization was high from April through October 2020, representing 15% to 20% of new-patient visits and 20% to 25% of established-patient visits. In a survey offered to all clinicians, 96% of respondents indicated they are using telemedicine, with 33% using it for more than 25% of patient encounters. Among respondents, 59% reported that the use of telemedicine helps expedite diagnosis and treatment more than seeing patients in person in the clinic, 55% of respondents managed urgent issues by telemedicine, 80% believed that patients benefited From urgent assessment by telemedicine, and 57% believed an emergency department visit or a hospitalization was avoided because of a telemedicine visit. Most clinicians reported that patients enjoy benefits of telemedicine because of decreased exposure risk, decreased transportation requirements, and ease of including caregivers in the visit with the treating clinician. The most common barriers to patients accessing telemedicine were technical challenges and broadband access. Despite this, less than 5% of respondents routinely use telephone-only communication, as most typically use bimodal audio/video communication. Many clinicians have expansion ideas on how telemedicine can further expand the longitudinal care delivery for our patient population. CONCLUSIONS: Telemedicine can be implemented successfully across a large statewide oncology practice and service a high volume of patients. Clinicians utilize telemedicine for new and established patients with minimal dysfunction. Clinicians believe patients benefit From telemedicine For new, established, and urgent care visits. Broadband access functionality should be explored to optimally serve our patient population.


Subject(s)
/epidemiology , Neoplasms/therapy , Telemedicine/organization & administration , Health Insurance Portability and Accountability Act/standards , Humans , Inservice Training , Telemedicine/standards , Telemedicine/statistics & numerical data , United States
18.
Front Public Health ; 8: 600213, 2020.
Article in English | MEDLINE | ID: covidwho-1005650

ABSTRACT

The shudders of the COVID-19 pandemic have projected newer challenges in the healthcare domain across the world. In South American scenario, severe issues and difficulties have been noticed in areas like patient consultations, remote monitoring, medical resources, healthcare personnel etc. This work is aimed at providing a holistic view to the digital healthcare during the times of COVID-19 pandemic in South America. It includes different initiatives like mobile apps, web-platforms and intelligent analyses toward early detection and overall healthcare management. In addition to discussing briefly the key issues toward extensive implementation of eHealth paradigms, this work also sheds light on some key aspects of Artificial Intelligence and the Internet of Things along their potential applications like clinical decision support systems and predictive risk modeling, especially in the direction of combating the emergent challenges due to the COVID-19 pandemic.


Subject(s)
Delivery of Health Care/organization & administration , Information Dissemination/methods , Internet of Things/organization & administration , Mobile Applications , Pandemics , Telemedicine/organization & administration , Humans , South America
19.
BMJ Open ; 10(12): e042647, 2020 12 31.
Article in English | MEDLINE | ID: covidwho-1004171

ABSTRACT

OBJECTIVES: The COVID-19 outbreak in Singapore has largely centred around migrant worker dormitories, comprising over 90% of all cases in the country. Dormitories are home to a culturally and linguistically distinct, low-income population, without on-site healthcare after-hours. The primary objective of this study was to assess the engagement and utilisation of a simple, low-cost, accessible, mobile health solution for remote self-reporting of vital parameters in dormitory residents with COVID-19. DESIGN: Retrospective review of medical care. SETTING: Two large migrant worker dormitories with a combined population of 31 546. PARTICIPANTS: All COVID-19-affected residents housed in dormitories during the study period. INTERVENTION: All residents were taught to use a chat assistant to self-report their temperature, heart rate and oxygen saturations. Results flowed into a dashboard, which alerted clinicians of abnormal results. OUTCOMES: The primary outcome measure was engagement rate. This was derived from the total number of residents who registered on the platform over the total number of COVID-19-affected residents in the dormitories during the study period. Secondary outcome measures included outcomes of the alerts and subsequent escalations of care. RESULTS: 800 of the 931 COVID-19-affected residents (85.9%) engaged with the platform to log a total of 12 511 discrete episodes of vital signs. Among 372 abnormal readings, 96 teleconsultations were initiated, of which 7 (1.8%) were escalated to emergency services and 18 (4.9%) were triaged to earlier physical medical review on-site. CONCLUSIONS: A chat-assistant-based self-reporting platform is an effective and safe community-based intervention to monitor marginalised populations with distinct cultural and linguistic backgrounds, living communally and affected by COVID-19. Lessons learnt from this approach may be applied to develop safe and cost-effective telemedicine solutions across similar settings.


Subject(s)
Communicable Disease Control/methods , Remote Consultation , Telemedicine , Transients and Migrants/statistics & numerical data , Adult , /epidemiology , Cost-Benefit Analysis , Diagnostic Self Evaluation , Health Services Accessibility , Housing/organization & administration , Humans , Internet-Based Intervention , Male , Remote Consultation/economics , Remote Consultation/methods , Retrospective Studies , Singapore/epidemiology , Social Marginalization , Telemedicine/methods , Telemedicine/organization & administration
20.
Ann Acad Med Singap ; 49(11): 905-908, 2020 11.
Article in English | MEDLINE | ID: covidwho-1001064

ABSTRACT

The ongoing pandemic in Singapore is part of a global pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To control the spread of COVID-19 and prevent the healthcare system from being overwhelmed, 'circuit breaker' measures were introduced between 7 April and 1 June 2020 in Singapore. There is thus a crucial need for innovative approaches to the provision and delivery of healthcare in the context of safe-distancing by harnessing telemedicine, especially for patients with chronic diseases who have traditionally been managed in tertiary institutions. We present a summary of how the Virtual Monitoring Clinic has benefited the practice of our outpatient rheumatology service during the COVID-19 pandemic. The virtual consultations address the need for safe-distancing by limiting face-to-face appointments and unnecessary exposure of patients to the hospital where feasible. This approach ensures that the patients are monitored appropriately for drug toxicities and side-effects, maintained on good disease control, and provided with patient education.


Subject(s)
Antirheumatic Agents/therapeutic use , Rheumatic Diseases/drug therapy , Rheumatology/methods , Telemedicine/methods , Ambulatory Care/methods , Delivery of Health Care , Humans , Nurse Practitioners , Pharmacists , Singapore , Telemedicine/organization & administration , Tertiary Care Centers
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