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Mov Disord ; 35(10): 1701-1711, 2020 10.
Article in English | MEDLINE | ID: covidwho-726315


BACKGROUND: The COVID-19 pandemic restricted usual healthcare management for movement-disorders patients, with a consequent upsurge in telemedicine to bridge the gap. OBJECTIVE: To assess global telemedicine usage in the context of the pandemic. METHODS: The Movement Disorder Society (MDS) Telemedicine Study Group surveyed telemedicine experts from 40 countries across all continents in March-April 2020. Four domains of telemedicine were assessed: legal regulations, reimbursement, clinical use, and barriers; comparing emerging responses to the pandemic versus the baseline scenario. RESULTS: All forms of telemedicine for movement disorders increased globally, irrespective of country income categorization, as an immediate response to the pandemic. This was aided by widespread availability of technology and updated government regulations. However, privacy concerns, lack of reimbursement, limited access, and lack of telemedicine training were barriers highlighted worldwide. CONCLUSIONS: Questions remain about the longevity and extent of changes in regulations and reimbursement regarding telemedicine in the aftermath of the pandemic. © 2020 International Parkinson and Movement Disorder Society.

Coronavirus Infections/economics , Movement Disorders/drug therapy , Pandemics/economics , Pneumonia, Viral/economics , Reimbursement Mechanisms , Telemedicine , Betacoronavirus/pathogenicity , COVID-19 , Female , Humans , Male , SARS-CoV-2 , Surveys and Questionnaires , Telemedicine/economics
Indian J Med Ethics ; V(2): 103-105, 2020.
Article in English | MEDLINE | ID: covidwho-251004


It is now well established that non-communicable diseases (NCD), like diabetes mellitus, hypertension,, respiratory and heart disease, particularly among the elderly, increase the susceptibility to COVID-19 disease. Mortality in 60%-90% of the COVID-19 cases is attributed to either one or more of these comorbidities. However, healthcare management for control of COVID-19 involves public health and policy decisions that may critically undermine the existing health needs of the most vulnerable NCD patients. Temporary closure of outpatient health facilities in some secondary and tertiary care hospitals have deprived millions of NCD patients of their regular medication and diagnostic health needs. The lack of robust primary healthcare facilities in most states, and the failure to maintain physical distancing norms due to inadequate infrastructure is also problematic. In the absence of effective public health interventions, socioeconomically vulnerable patients are likely to become non-adherent increasing manifold their risk of disease complications. In this context, the feasibility of dispensing longer than usual drug refills for chronic NCD conditions at functional government health facilities, home delivery of essential drugs, running dedicated NCD clinics at PHCs, and utilisation of telemedicine opportunities for care and support to patients warrant aggressive exploration. Keywords: Covid-19, NCDs, Medical ethics, epidemic, India.

Coronavirus Infections , Delivery of Health Care , Health Services Accessibility , Noncommunicable Diseases , Pandemics , Pneumonia, Viral , Vulnerable Populations , Ambulatory Care Facilities , Betacoronavirus , COVID-19 , Coronavirus Infections/epidemiology , Health Services Accessibility/ethics , Health Services Needs and Demand , Humans , India/epidemiology , Noncommunicable Diseases/therapy , Pneumonia, Viral/epidemiology , Primary Health Care , SARS-CoV-2 , Telemedicine