Telemedicine journal and e-health : the official journal of the American Telemedicine Association
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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.
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Background: Video telehealth is an important tool for health care delivery during the COVID-19 pandemic. Given physical distancing recommendations, access to traditional in-person telehealth training for providers has been limited. Telesimulation is an alternative to in-person telehealth training. ⋯ Postsession, participants reported increased comfort with some advanced InTouch features, including taking and sharing pictures with the patient (p < 0.01) and drawing on the shared image (p < 0.05), but less comfort with troubleshooting technical issues, including audio and stethoscope (p < 0.01). Frequently stated concerns were troubleshooting technical issues during a call (75%, n = 16) and personal discomfort with telemedicine applications and technology (56%, n = 16). Conclusion: Large group telesimulation is a feasible way to offer telehealth training for physicians and can increase provider comfort with telehealth software.
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Background: At the beginning of the COVID-19 pandemic, New York City quickly became the epicenter with hospitals at full capacity needing to care for patients. At New York Presbyterian Brooklyn Methodist Hospital, we needed to develop an innovative system of how to safely discharge the massive influx of patients. Inundation of patient care with limited manpower and resources forced us to align with a third-party vendor, around-the-clock alert, to make remote patient monitoring (RPM) possible. ⋯ We had a high compliance rate with high patient satisfaction in postsurveys. Discussion: Our program was unique in that it utilized telemedicine for regular patient follow-up, along with RPM through a third-party vendor. Patients were able to be safely discharged home with close follow-up through regularly obtained vitals with access to a 24/7 hotline for any emergencies, possibly preventing readmissions. Limitations include a small sample size population. Conclusions: Our experience shows that in a short period despite lack of resources, telehealth and RPM's concurrent use with a third-party vendor could be successfully utilized for safe discharges with high patient satisfaction.
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Observational Study
Teleneurology as a Solution for Outpatient Care During the COVID-19 Pandemic.
Background: The coronavirus disease of 2019 (COVID-19) pandemic and the need for social distancing have dramatically changed health care delivery. There is an urgent need to continue to deliver outpatient care for chronic neurological disease and teleneurology has the potential to fulfill this gap. Introduction: This study reports the implementation and utilization of teleneurology across all neurological subspecilities during the COVID-19 pandemic. ⋯ Discussion: In a relatively short time frame of 3 weeks, a single academic center was able to dramatically increase teleneurology visits to provide outpatient neurological care. Conclusions: This study demonostrates that teleneruology can be a solution for outpatient neurological care in the context of COVID-19. The increased utilization of teleneurology during this crisis has the potential to expand teleneurology and improve access to neurological care in the future outside the pandemic setting.
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Recent studies published in the Telemedicine and e-Health journal stated the reality in Italy of the importance of telemedicine promotion during the coronavirus 2019 (COVID-19) pandemic. In Italy, we gradually approached the second phase of the COVID-19 pandemic. During this phase, the activities restarted according to a temporal plan. ⋯ Telemedicine is still important and must also be rethought. The study, starting from the needs of chronic patients, highlighted in the recent studies published in this journal, expanded the possibilities of multiple opportunities for telemedicine integration during the second phase. An emerged categorization takes into consideration (1) the subjects with fragility, including those with rare diseases; (2) the experience gained during the emergency; (3) the new opportunities emerged for telemedicine boundaries; and (4) the new needs for telemedicine-based pulmonary rehabilitation at home.