Telehealth Experience Research Articles

Implementing video visits into an orthopedic hip arthroscopy practice: a case study.

Telehealth videoconferencing has been shown to be feasible, cost-effective and safe in numerous fields of medicine. In an effort to increase access and improve the quality of care offered to patients we implemented a telehealth initiative allowing for remote orthopedic clinic visits at a major academic medical center. Here we report on our experience and early outcomes. A telehealth platform was launched for a single fellowship trained orthopedic surgeon at a major academic hospital in August 2018. New patients residing outside the metro area, all return patients and patients with an uncomplicated post-operative course were offered the option to complete patient encounters remotely via a telehealth platform. Each patient was offered a Patient Satisfaction Survey following video visit. Patient zip codes were used to estimate patient commutes. Ninety-six percent of patients agreed/strongly agreed with the statement ‘I was satisfied with my Telehealth experience’ while 51% agreed/strongly agreed with the statement ‘This visit was just as good as a face to face visit’. In all, 94% of patients agreed/strongly agreed with the statement ‘Having a telehealth visit made receiving care more accessible for me’. The median miles saved on commutes were 123.3 miles. The no show rate for telehealth visits was 8.2% versus 3.2% for in-person (P < 0.001). Telehealth video visits provided patients with a modality for completing orthopedic clinic visits while maintaining a high-quality care and patient satisfaction. Patient convenience was optimized with video visits with elimination of long commutes. Level of evidence: IV.

Implementation and evaluation of a virtual objective structured clinical examination for pharmacy students

AbstractIntroductionThe University of California, San Francisco (UCSF) School of Pharmacy employs Objective Structured Clinical Examinations (OSCEs) to assess students' skills. The Coronavirus disease 2019 (COVID‐19) pandemic made in‐person OSCEs infeasible. This article describes the implementation and evaluation of a two‐station virtual OSCE (vOSCE) for first‐year pharmacy students.MethodsA summative vOSCE was conducted in June 2020 using Zoom and ExamSoft. Faculty and residents served as standardized patients (SPs) and evaluated student performance. Students and SPs were surveyed on their perceptions post‐vOSCE. A mixed methods analysis was conducted, incorporating thematic analysis of survey responses and quantitative analyses of student performance on the virtual vs in‐person OSCE.ResultsNinety‐six (75%) students and 17 SPs (94.4%) completed the survey. Students and SPs (69% vs 88%, P = .10) felt that vOSCEs were acceptable alternatives for demonstrating knowledge, communication, and telehealth skills. SPs felt that in‐person OSCEs were more effective to assess communication skills and ability to conduct in‐person encounters (P &lt; .05). Qualitative comments from students and SPs corroborated these differences, emphasizing limitations of vOSCEs for demonstrating nonverbal skills, and additional considerations regarding exam administration and assessment. Students who failed an OSCE generally had lower median communication scores (P &lt; .01). Technological difficulties, before OSCE performance, and before telehealth experience were not associated with passing the vOSCE (P &gt; 0.05).DiscussionThe virtual environment did not seem to negatively impact student performance. However, students and SPs felt vOSCEs may be less effective to demonstrate and assess nonverbal communication. To address these limitations, future implementation of vOSCEs may include providing students with instruction on nonverbal telehealth skills and SP training on virtual assessment of nonverbal communication skills.

Telehealth experience of endocrinology research centre

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Key Considerations in Ensuring a Safe Regional Telehealth Care Model: A Systematic Review.

Background: This literature review sets out to increase the knowledge on patient safety within the telehealth modality of care, to inform the relevant local health service departments on the key considerations to minimize patient harm. Methods: A systematic search in Medline and Cumulative Index to Nursing and Allied Health Literature (CINAHL), Google Scholar, and the University of New England (UNE) Library Search was conducted. A combination of key terms "Telehealth" OR "Telecare" OR "Telemedicine" AND "patient safety" AND "rural" was used. Based on the screening and eligibility criteria, 21 peer-reviewed articles published in English between 2015 and 2020 were included in the review. Results and Discussion: On evaluating the included studies, three main themes and various corresponding subthemes emerged. The main themes were that of telehealth experience (TE), telehealth outcomes (TO), and telehealth risks (TR), with the corresponding subthemes of telehealth experience from a patient perspective (TE-PT), telehealth experience from a carer perspective (TE-CR), telehealth experience from a clinician perspective (TE-CN), positive telehealth (TO-P), and negative telehealth outcomes (TO-N), and patient (TR-PT) and clinician telehealth risks (TR-CN). Conclusions: The results suggest that patients generally have positive experiences and are accepting telehealth as a modality of care. Furthermore, patient outcomes appear to be comparable with in-person care, with additional benefits of lower costs to both the service and patients.

Evaluating the Experiences of New and Existing Teledermatology Patients During the COVID-19 Pandemic: Cross-sectional Survey Study.

BackgroundAs teledermatology has been widely adopted during the COVID-19 pandemic, it is essential to examine patients’ experiences and satisfaction with teledermatology.ObjectiveWe aimed to assess the teledermatology experiences of new and existing clinic patients in the context of the rapid shift toward teledermatology practices during the COVID-19 pandemic.MethodsWe conducted a cross-sectional study of 184 teledermatology patients who were assessed during the COVID-19 pandemic at a major southeastern medical center from May 13 to June 5, 2020. The primary outcome was patient satisfaction levels among new and existing patients. The secondary outcome was patients’ willingness to use teledermatology in the future.ResultsOf the 288 teledermatology patients who were assessed during the study period, 184 (63.9%) completed the survey. Patients reported high overall satisfaction with teledermatology, with 86.4% (159/184) of participants reporting positive overall satisfaction and experiences with teledermatology. New patients had significantly higher Likert scores for overall satisfaction with teledermatology than those of follow-up patients (new patients: mean 4.70; existing patients: mean 4.43; P=.03). Overall, patients’ satisfaction with teledermatology did not significantly differ based on age (P=.36), race and ethnicity (P=.46), education level (P=.11), residence (P=.74), or insurance status (P=.74). There were no significant differences in overall satisfaction between patients with and without prior telehealth experience (P=.53), between the video and telephone visit types (P=.17), and among platform types (P=.22). Prior telehealth experience was associated with higher odds of being willing to use telehealth in the future (odds ratio 2.39, 95% CI 1.31-4.35; P=.004).ConclusionsThis cross-sectional survey study demonstrates that during the rapid expansion of teledermatology, new clinic patients had significantly higher scores for overall satisfaction with their teledermatology experience compared to those of established clinic patients (P=.03). Prior telehealth experience was associated with higher odds of being willing to use teledermatology in the future. Overall, teledermatology expansion was met with high levels of patient satisfaction during the COVID-19 pandemic.

657 Patient Perspectives on Telesleep Care in COVID Times: An Urban Teaching Hospital Survey

IntroductionTelehealth is a relatively new tool for patient care, and to reach underserved areas where certain specialties are available. With the advent of the COVID19 pandemic, Telehealth has become a universal way to provide safe and quality patient care. However, Telehealth is a new experience for many providers and patients. We surveyed patients who received telehealth visits in sleep medicine between March and June 2020 to determine patient satisfaction and common technology-related barriers. The goal was to formulate actionable steps for improving patient’s experiences and determine the feasibility of long-term telehealth services for sleep medicine.MethodsWe interviewed 63 patients by phone, utilizing IRB approved surveys for telehealth satisfaction and technology. Responses were de-identified, tabulated, and analyzed in aggregate using Excel®.Results85% of respondents had a high-school diploma or a higher level of education (9.6% students, 39.7% employed, 15.9% unemployed, and 19% retirees). 62% of participants participated in Telehealth for the first time. 89% preferred Telehealth, and 76% rated telehealth experience as good or better than in-person visits. 92% did not require technical assistance during the visit. Long-term telehealth care was acceptable to 63% of participants. Approximately 33% had technology-related barriers (no computer or webcam), and 12% did not have email. However, 89% had smartphones (70% connected to personal internet). Other barriers cited were lack of private space (13%) and taking time off work (9%). No clear preference for phone versus video Telehealth was noted (approximately 40% each), but 7% expressed concern about bi-directional video communication. This may be related to the privacy and security concerns expressed by 20% of respondents. However, only 5% reported using the electronic health record (EHR) based secure communication portal.ConclusionSleep care via Telehealth is preferred by most patients during the COVID pandemic and is acceptable to two-thirds of patients for the long-term. In addition to access to personal devices or the internet, privacy concerns were a barrier to Telehealth. We plan to increase patient enrollment in the EHR-based portal to deliver telehealth services and communication securely to mitigate these barriers.Support (if any):

Understanding patients' views and willingness toward the use of telehealth in a cancer genetics service in Asia.

Telehealth is a growing field, its pertinence magnified by COVID-19 causing the accelerated digitalization of the world. Given the significant global demand to provide telehealth services, it is important to explore patient receptiveness toward this alternative service model, particularly from regions where it has yet to be implemented. We conducted a cross-sectional study to understand the views and willingness of patients toward the use of telehealth for cancer genetic counseling. A survey was completed by 160 patients of the National Cancer Centre Singapore, and descriptive statistics were used to analyze the data. The study found that 95.6% (n=153/160) of participants did not have prior telehealth experience. Most participants were willing or neutral toward having genetic counseling by phone (n=114/160, 71.3%) and video (n=106/160, 66.3%). However, majority prefer in-person appointments for first (n=127/160, 79.4%) and follow-up (n=97/160, 60.6%) visits over telehealth. Majority agreed that a phone/video consultation would meet most of their needs but voiced concerns regarding privacy and sharing of information (n=79/160, 49.4% for phone; n=74/160, 46.3% for video) and whether their emotional needs could be met (n=61/160, 38.1%). Participants' age, employment status, income, mode of transportation to the appointment, and whether special arrangements were made to attend the in-person appointment were associated with receptivity to telehealth genetic counseling (p≤.05 for all). This study adds diversity to existing literature and demonstrates that patients from Asia are generally willing and accepting of the use of telehealth in a cancer genetics service. This will help meet increasing global demand of telehealth consultations in the post-pandemic new norm. Furthermore, it will also provide services for underserved populations and patients requiring urgent testing in a timely manner. Further studies are needed to explore the cost-effectiveness and fair billing methods, as well as willingness and acceptability of telehealth genetic counseling in post-COVID times.

Rapid Curricular Innovations During COVID-19 Clinical Suspension: Maintaining Student Engagement with Simulation Experiences.

Health care education programs were faced with the need to quickly adapt to a new reality during the coronavirus disease 2019 pandemic. Students were temporarily suspended from campus and clinical sites, requiring prompt changes in structure to their didactic and clinical learning. This article describes the rapid adjustments that one midwifery and women's health nurse practitioner education program created using both synchronous and asynchronous simulation experiences to promote student learning and ongoing engagement. Flexibility and reflexivity were needed by faculty and students alike in the face of the multiple changes wrought by the pandemic. Curricular changes were made simultaneously in many courses. Objective structured clinical examinations simulate telehealth experiences that assess knowledge, clinical reasoning, and professional behaviors via a scripted scenario and an actor patient. On-call simulations mimic telephone triage and provide students the opportunity to build listening, assessment, and management skills for prenatal and intrapartum scenarios. Students are provided equipment and virtual instruction in an intrauterine device insertion session, which promotes skill acquisition and self-confidence. Trigger films are used to visualize real-life or scripted clinical encounters, leading to discussion and decision-making, particularly in the affective domain. Bilateral learning tools, similar to case studies, provide students an opportunity to demonstrate their knowledge and critical thinking with a mechanism for faculty feedback. Web-based virtual clinical encounter learning tools using patient avatars prompt additional student learning. Suturing skills introduced in live remote group sessions are augmented with video-guided individual practice. This article describes each of these adapted and innovative simulation methods and shares lessons learned during their development and implementation.

The experience of Australian general practice patients at high risk of poor health outcomes with telehealth during the COVID-19 pandemic: a qualitative study

BackgroundThe emergence of the COVID-19 pandemic has raised concerns about the potential decrease in access and utilisation of general practice services and its impact on patient care. In March 2020, the Australian Government introduced telehealth services to ensure that people more vulnerable to COVID-19 do not delay routine care from their general practitioners. Evidence about patients’ experience of telehealth and its impact on patient care is scarce. This study aimed to investigate the experience with telehealth by Australian general practice patients at high risk of poor health outcomes during the COVID-19 pandemic.MethodsSemi-structured telephone interviews were conducted with 30 patients from nine general practices in metropolitan Adelaide (May–June 2020). Participants were identified by their regular doctor as being at high risk of poor health outcomes. Interviews sought participants’ perspectives and experiences about telehealth services in the general practice setting during COVID-19, and the value of offering continued telehealth services post pandemic. Interviews were recorded and transcribed verbatim. Data were analysed using a coding structure developed based on deductive codes derived from the research questions and any additional concepts that emerged inductively from interviews.ResultsParticipants expressed satisfaction with telehealth including convenient and timely access to general practice services. Yet, participants identified challenges including difficulties in expressing themselves and accessing physical exams. Prescription renewal, discussing test results and simple follow-ups were the most common reasons that telehealth was used. Telehealth was mainly via phone that better suited those with low digital literacy. Participants indicated that an existing doctor-patient relationship was important for telehealth services to be effective. Subjects believed that telehealth services should be continued but needed to be combined with opportunities for face-to-face consultations after the COVID-19 pandemic was over.ConclusionsThe expansion of telehealth supported access to general practice including chronic disease management during the COVID-19 pandemic. In the future, telehealth in Australia is likely to have a stronger place in primary healthcare policy and practice and an increased acceptance amongst patients.

Patient and family perceptions of telehealth as part of the cystic fibrosis care model during COVID-19

BackgroundCystic Fibrosis (CF) is a chronic multi-system disease best cared for at Care centers with routine monitoring by interdisciplinary teams. Previously, remote home monitoring technology has been explored to augment in-person care. During the COVID-19 pandemic, traditional in-person care was limited and CF centers rapidly adapted to a telehealth delivery model. The purpose of this study was to understand how people with CF (PwCF) and families of PwCF experienced the shift to telehealthcare delivery. MethodsThis was a cross-sectional survey-based study conducted in 11 CF Centers. Two surveys were designed (one for adult PwCF and one for parents/guardians of PwCF) by participating CF center members with patient and family partner input. Surveys were disseminated electronically via email/text to all patients who completed a telehealth visit, and data were collected on secure Google Forms. ResultsRespondents rated their telehealth experiences as positive. Most were highly satisfied with their telehealth visit (77% adult, 72% pediatric) and found the visits to be highly convenient (85% for all surveyed). A majority of patients reported they had adequate time during the visit and had all questions and concerns addressed. Importantly, we also identified concerns regarding lack of in-person assessments including pulmonary function testing (PFT) and throat/sputum culture. ConclusionTelehealth was a feasible and well-accepted mechanism for delivering care in a chronic CF care model during the COVID-19 pandemic and may be useful in the post-pandemic era. Further work is needed to understand the impact of telehealth on patient outcomes, healthcare utilization and associated cost.

Patient experiences with telehealth in sleep medicine: a qualitative evaluation.

The field of sleep medicine has been an avid adopter of telehealth, particularly during the COVID-19 pandemic. The goal of this study was to assess patients' experiences receiving sleep care by telehealth. From June 2019 to May 2020, the authors recruited a sample of patients for semi-structured interviews, including patients who had 1 of 3 types of telehealth encounters in sleep medicine: in-clinic video, home-based video, and telephone. Two analysts coded transcripts using content analysis and identified themes that cut across patients and categories. The authors conducted interviews with 35 patients and identified 5 themes. (1) Improved access to care: Patients appreciated telehealth as providing access to sleep care in a timely and convenient manner. (2) Security and privacy: Patients described how home-based telehealth afforded them greater feelings of safety and security due to avoidance of anxiety-provoking triggers (eg, crowds). Patients also noted a potential loss of privacy with telehealth. (3) Personalization of care: Patients described experiences with telehealth care that either improved or hindered their ability to communicate their needs. (4) Patient empowerment: Patients described how telehealth empowered them to manage their sleep disorders. (5) Unmet needs: Patients recognized specific areas where telehealth did not meet their needs, including the need for tangible services (eg, mask fitting). Patients expressed both positive and negative experiences, highlighting areas where telehealth can be further adapted. As telehealth in sleep medicine continues to evolve, the authors encourage providers to consider these aspects of the patient experience. Donovan LM, Mog AC, Blanchard KN, et al. Patient experiences with telehealth in sleep medicine: a qualitative evaluation. J Clin Sleep Med. 2021;17(8):1645-1651.

Access to sexual healthcare during New Zealand’s COVID-19 lockdown: cross-sectional online survey of 15–24-year-olds in a high deprivation region

BackgroundNew Zealand’s response to the COVID-19 pandemic involved a nationwide stay-at-home lockdown in March–April 2020 that restricted access to primary healthcare services.MethodsAn online survey of 15–24-year-olds in a high deprivation...

Psoriasis and Psoriatic Arthritis in the Context of the COVID-19 Pandemic: A Plenary Session From the GRAPPA 2020 Annual Meeting.

The coronavirus disease 2019 (COVID-19; caused by SARS-CoV-2) pandemic has affected the healthcare system on a global scale, and we utilized the Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA) 2020 annual meeting to examine how COVID-19 might affect patients with psoriatic disease (PsD) and the clinicians who care for them. Pressing issues and concerns identified included whether having psoriasis increased the risk of acquiring COVID-19, vaccine safety, and the acceptability of telehealth. The general message from rheumatologists, dermatologists, infectious disease specialists, and patient research partners was that data did not suggest that having PsD or its treatment significantly increased risk of infection or more severe disease course, and that the telehealth experience was a success overall.

Abstract S06-04: Telehealth experiences of adolescent and young adult cancer patients and survivors during the COVID-19 pandemic

Abstract Purpose: To describe adolescent and young adult (AYA) cancer patients’ and survivors’ experiences with telehealth during the COVID-19 pandemic. Methods: Eligible participants were identified through the Huntsman Intermountain Adolescent and Young Adult Cancer Care Program, which provides age-specific programming and patient navigation to AYA cancer patients and survivors in Utah and surrounding Mountain West states. Participants were emailed an online survey if they were currently age 18 or older and had been diagnosed with cancer between the ages of 15-39 years. We applied descriptive statistics to summarize demographics, comfortability with technology, access to reliable internet connection, and perceived quality of care while using telehealth. Results: AYAs (N=280) were an average of 29.4 years old at survey (range 18-58); 65.2% were female and 82.4% non-Hispanic white. Over half (54.2%) had received cancer treatment since March 2020. All participants reported owning a computer, tablet, and/or smart phone they could use for telehealth appointments. The majority (93.5%) reported almost always or always having a reliable internet connection. AYAs felt most comfortable having a telehealth appointment in their own home (96.4%); only 12.5% felt comfortable using telehealth at work. Since March 2020, (N=183) 65.4% had a health care visit moved to a telehealth platform due to COVID-19. Of those who recently moved to telehealth, 60.1% had an oncology visit, 33.9% had a primary care visit, and 31.1% had a mental health visit. Additionally over one-third (35.2%) reported the quality of their medical care had decreased since moving to telehealth. This was most commonly due to 1) troubles with audio, video, or connecting through telehealth platforms; 2) telehealth visits feeling impersonal; and 3) feeling that providers more easily dismissed or did not fully address their symptoms. Conclusions: Although AYAs are digital natives, over one-third of AYAs feel the quality of their medical care has decreased since moving to telehealth for COVID-19. Further research should explore medical provider training in using telehealth systems and encourage telehealth practices that help AYAs feel more supported and understood. Citation Format: Karely Mann, Austin R. Waters, Perla L. Vaca Lopez, Echo L. Warner, Judy Ou, Heydon Kaddas, Joemy Ramsay, Nicole Ray, Tomoko Tsukamoto, Douglas B. Fair, Joseph M. Letourneau, Mark A. Lewis, David Gill, Lauri Linder, Anne C. Kirchhoff. Telehealth experiences of adolescent and young adult cancer patients and survivors during the COVID-19 pandemic [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2021 Feb 3-5. Philadelphia (PA): AACR; Clin Cancer Res 2021;27(6_Suppl):Abstract nr S06-04.

Telehealth in Times of COVID-19: Spotlight on Austria.

Introduction: With the spread of Coronavirus disease 2019 (COVID-19), the world has been experiencing an extraordinary state of emergency. As patients entering a doctor’s practice can potentially infect medical staff and other patients, using digital alternatives wherever possible is a potential solution to avoiding face-to-face encounters. In these conditions, telemedicine is becoming increasingly relevant. Hence, the aim of this study was to examine telemedicine use and gathered experiences during the COVID-19 pandemic in Austria. Materials and Methods: In June 2020, a representative group of Austrian respondents (n = 1000) was asked via online survey whether they had contacted a doctor during spring of 2020, and, if so, whether they had used a telemedical method to do so. The survey also reflected gathered experiences and degrees of satisfaction with the use of telemedicine. Results: A third (33%) of those who contacted a doctor during the target period did so using telemedical tools. The majority of those with previous telehealth experience were satisfied with the help they received. Patients commonly used a telephone to contact their doctors. The overall assessment of telemedical aids tended to be positive, with more than half (53%) of those surveyed seeing significant advantages, and a 90% satisfaction rate among the respondents who used telehealth services. Conclusion: The outcomes from this work hint at fairly high acceptance of telemedical communication tools in the studied group of the Austrian population. Based on the high rate of satisfaction among patients who used telehealth, it is expected that the use of telehealth services will increase further in the near future.

1064 Patient satisfaction with telehealth visits: a contemporary study in the obstetrical population

In light of the COVID-19 pandemic, clinic visits have been transitioned to telehealth encounters. Current evidence has shown that the quality of telehealth visits compared to in-person visits have had similar health outcomes and patient satisfaction. We aim to gain an understanding of patient experience, perspective and satisfaction with telehealth visits at our institution in the obstetrical population. A cross-sectional survey assessing patient satisfaction was conducted among prenatal patients who received telehealth care at our outlaying clinics (conducted over the phone by providers and recently established to decrease person-to-person interaction in light of the COVID-19 pandemic). A validated satisfaction survey was conducted (15 questions using a 5-point Likert scale designed to gauge patient experience, perspective and satisfaction). Questions aim to measure convenience of visit, degree in which clinical/medical issues are addressed, concerns about privacy, preference over in-person prenatal visits, and overall satisfaction. A total of 232 patients were called; 138 chose to participate, 23 declined, and 71 were not reached. Results are summarized in Tables. The majority of patients expressed that their telehealth prenatal visit was just as good as an in-person visit, that their concerns and questions were clearly communicated to their providers, and that their condition or treatment were well explained. Additionally, the majority of patients reported that the visit was convenient, while saving them money and time. However, 71% of patients would still rather have an in-person clinic visit than use telehealth, despite being overall satisfied with their telehealth visit. Unsatisfied subjects reported less benefit in travel time, money savings and were less likely to recommend their telehealth experience to other patients (Table 2). Patients reported high satisfaction rates in their telehealth prenatal experience with additional benefits of saving time and money. It appears however, they still desired to see their providers in person for their prenatal care.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Preference for Telehealth Sustained Over Three Months at an Outpatient Center for Integrative Medicine.

BackgroundIntegrative medicine is a key framework for the treatment of chronic medical conditions, particularly chronic pain conditions. The COVID-19 pandemic prompted rapid implementation of telehealth services.ObjectiveWe present outcomes of a complete and rapid transition to telehealth visits at an outpatient integrative medicine center in the Southeastern United States.MethodPatients and administrative staff took surveys comparing telehealth to in-person visits within four weeks of our clinic's transition to telehealth and three months later. Beginning four weeks after the clinic’s telehealth conversion in March 2020, patients who had a telehealth visit at the center completed a survey about their telehealth experience and another survey three months later.ResultsPatient quality judgements significantly favored telehealth at baseline, B = .77 [0.29 – 1.25], SE = .25, t(712) = 3.15, p = .002, and increased at three months, B = .27 [–0.03 – 0.57], SE = .15, t(712) = 1.76, p = .079. Telehealth technology usability and distance from the center predicted patient ratings of telehealth favorability. Providers favored in-person visits more than patients, B = –1.00 [–1.56 – –0.44], SE = .29, t(799) = –3.48, p < .001, though did not favor either in-person or telehealth more than the other. Patient discrete choice between telehealth and in-person visits was split at baseline (in-person: n = 86 [54%]; telehealth: n = 73 [46%]), but favored telehealth at three months (in-person: n = 17 [40%]; telehealth: n = 26 [60%]). Overall, discrete choice favored telehealth at follow-up across providers and patients, OR = 2.69 [.1.18 – 6.14], z = 2.36, p = .018. Major qualitative themes highlight telehealth as acceptable and convenient, with some challenges including technological issues. Some felt a loss of interpersonal connection during telehealth visits, while others felt the opposite.ConclusionWe report converging mixed-method data on the successful and sustained implementation of telehealth with associated policy and clinical implications during and beyond the COVID-19 pandemic.

How Providers in Child Neurology Transitioned to Telehealth During COVID-19 Pandemic.

To understand child neurology care practices in telehealth (TH), we conducted an online survey interested in identifying which patients should be triaged for in-person evaluations in lieu of telehealth management. We also sought to identify provider and patient/parent limitations of the TH experience. One hundred fourteen clinicians completed the online survey. The majority of child neurologists transitioned within 3 weeks of the pandemic onset and found it inappropriate to evaluate a child under 1 year of age via TH. We identified specific disorders considered inappropriate for initial evaluation via TH, including neuromuscular disease, neuropathy, weakness, autoimmune disease and autism spectrum disorders. Patient and parent technical and economic issues are significant limitations of TH. We suggest quality improvement measures to provide additional training, focusing on particular disorders and increased access for those patients currently excluded from or limited in using or accessing TH.

Curricular response to COVID-19: real-time interactive telehealth experience (RITE) program

ABSTRACT Introduction. The COVID-19 pandemic placed an unprecedented strain on academic healthcare systems necessitating a pause in medical student teaching in clinical care settings, including at Weill Cornell Medicine (WCM). WCM had a preexisting telemedicine curriculum, but limited opportunities for students to apply knowledge and skills related to direct virtual patient care. The authors describe the rapid implementation of real-time interactive telehealth experience (RITE) courses for clerkship students to allow for meaningful engagement in remote patient care and continuation of academic progress during the pause. Methods of Course Development. Medical school administration disseminated a request for proposals for RITE courses conforming to the WCM electives format with rapid turnaround time of 1 week or less. Requirements included remote care activities, goals and objectives, general logistics, supervision methods and standards of achievement. RITE courses were developed in outpatient medicine, inpatient medicine, psychiatry and women’s health. A lottery process was developed to register students for the approved courses. Course Implementation and Evaluation. Using the technical platform and standard course registration process, students were assigned to 74 of 76 available RITE course slots. Students participated in supervised remote direct patient care and also provided critical support for frontline healthcare workers by performing remote clinical tasks. Online teaching and reflection sessions were incorporated into each RITE curricular offering. Student feedback was overall positive ranging from 3.33–4.57 out of 5. Discussion. The COVID-19 pandemic created a need to rapidly incorporate telehealth models in order to continue to deliver patient care and an opportunity to develop innovative remote educational experiences. We developed a framework for structured real-time interactive telehealth experiences to address COVID-19 related curricular needs that will be continued post-COVID-19. This expanded telehealth curriculum for our students will provide standardized training in telehealth logistics, communication techniques, and care delivery now essential for graduating medical students.

Rapid Transition of an Allied Health Clinic to Telehealth During the COVID-19 Pandemic: Satisfaction and Experience of Health Professionals, Student Practitioners, and Patients

Purpose: With COVID-19 social distancing measures requiring a shift in how healthcare is delivered, telehealth service provision allows patients to receive care remotely while adhering to relevant safety regulations. This study investigated the perceptions and experiences of allied health practitioners and their patients at a multidisciplinary allied health clinic that rapidly transitioned to telehealth service delivery. Method: Allied health practitioners (both qualified and student) and patients were recruited during the transition to telehealth across a large healthcare facility located on the Gold Coast, Australia. Participants were surveyed after each telehealth session rating their satisfaction and experience across four areas (technical, administrative and operational, privacy, communication). Descriptive statistics were used to express categorical variables and a chi-square test of independence was applied to determine the presence of any associations. Results: Surveys (n=197) were collected from allied health practitioners (n = 31) and their patients (n = 70). Overall, high levels of satisfaction and experience with telehealth among patients and a consensus in satisfaction and experience among exercise physiology, physiotherapy and psychology practitioners were reported. Speech pathology student practitioners rated their satisfaction and telehealth experience significantly (p &lt; 0.001) lower than other disciplines. A significant relationship [χ2 (2, n = 127) = 7.49, p = .02] between student practitioners and the impact of telehealth on achieving session goals and outcomes was also identified. Conclusions: This study highlights complexities related to the acceptability and adoption of telehealth, technical aspects, and user functionality which contribute to the growing body of evidence supporting digital health technologies in the delivery and access to allied health services. In a multidisciplinary context, this study advocates for the consideration of discipline-specific issues when designing and implementing digital health services.