Telemedicine journal and e-health : the official journal of the American Telemedicine Association
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Background: The cororavirus disease 19 (COVID-19) pandemic has strained intensive care unit (ICU) material and human resources to global crisis levels. The risks of staffing challenges and clinician exposure are of significant concern. One resource, telecritical care (TCC), has the potential to optimize efficiency, maximize safety, and improve quality of care provided amid large-scale disruptions, but its role in pandemic situations is only loosely defined. ⋯ The design was meant to workforce efficiencies, reduce PPE use, and minimize health care worker exposure risk, all while maintaining quality care standards through an intensivist-led model. As health care operations resumed and states reopened, TCC is being used to support shifts in volume and critical care personnel during the pandemic evolution. The lessons applied may help health care systems through variable phases of the pandemic.
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Introduction: Telehealth is a rapidly expanding health care delivery modality with increasing utility in the health care community. It is imperative that telehealth education is provided during the training of health care providers to ensure the proper usage and application of this health care delivery system. A comprehensive literature review of telehealth education integrated into the curricula of physician, physician assistant, and advanced practiced registered nurse training programs has not been reported to date. Materials and Methods: An electronic literature search was performed using Scopus®, PubMed, and 17 of the 35 databases on the EBSCOHost platform. ⋯ Comparison of these articles showed no consistency in how telehealth was integrated into the various health care curricula. Content delivered usually included basic telehealth information, however, the depth and breadth of content varied significantly based on the interventions. Discussion: For the articles included in this review, there were no formal study designs regarding basic telehealth educational integration or competencies. While authors recommended conducting evaluation and determining the effectiveness of the interventions, they did not provide a clear picture as to how these efforts should be conducted. Conclusions: In addition to developing a standardized telehealth curriculum, national competencies need to be created, which will guide the development of standardized curriculum across health care training programs.
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Telehealth is an important tool utilized to provide remote clinical care and has increased in prevalence during the coronavirus disease of 2019 (COVID-19) pandemic. It allows providers to conduct safe, timely, and high-quality ambulatory care for patients without increasing risk of disease exposure for both parties. Major organizations including the Centers for Disease Control and Prevention and American College of Obstetrics and Gynecology have released recommendations encouraging the use of telehealth systems for patient care. ⋯ The authors have created such guidelines for use of telehealth in a moderate-risk academic generalist practice in response to the COVID-19 pandemic. This document highlights the process to determine which obstetrics and gynecology patients are candidates for telehealth, the frequency of follow-up, and the technical aspects of designing and delivering a de novo telehealth system. The guidelines were vital in providing structure amid a sudden transition in an academic setting while ensuring patient and provider safety.
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Background: The (COVID-19) pandemic resulted in sudden disruption of routine clinical care necessitating rapid transformation to maintain clinical care while safely reducing virus contagion. Introduction: Memorial Sloan Kettering (MSK) experienced a rapid evolution from delivery of in-person cessation counseling services to virtual telehealth treatments for our tobacco-dependent cancer patients. Aim: To examine the effect of rapid scaling of tobacco treatment telehealth on patient engagement, as measured by attendance rates for in-person counseling visits versus remote telehealth counseling visits. ⋯ Discussion: Clinical, Information Technology (IT), and hospital system barriers were successfully addressed for most cancer patients seeking individual telehealth treatment. Group telehealth services were found to be feasible and acceptable. Conclusions: MSK's rapid leap into virtual care delivery mitigated disruption of tobacco treatment services and demonstrated strong feasibility and acceptance for managing complex tobacco-dependent patients.
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Background: Rural hospitals struggle to staff inpatient services and may not have the clinical expertise to achieve optimal outcomes. Telehospitalist services could address these problems by bringing hospital medicine expertise to rural communities. Introduction: Veterans Health Administration (VHA) rural hospitals need staffing alternatives to address gaps in inpatient coverage. ⋯ Administrators were enthusiastic about applying innovative inpatient telemedicine initiatives, but perceived staff reluctance. The dynamic and multidisciplinary nature of inpatient care requires program acceptance at multiple levels, which may account for why it traditionally lags behind outpatient telemedicine. Conclusions: Rural hospital physician administrators perceived telehospitalist models as a viable option to address staffing needs and improve quality of care.